Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | E-0500051 | OH |
NPI | 1083001051 |
---|---|
Provider Name | Ms. Linda Mercury Fischbach |
First Address | Dayton, OH 45439-1521 |
Second Address | Dayton, OH 45439-1521 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2015 |
Last Update Date | 17/04/2015 |