Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | MH5134 | FL |
N | 101YM0800X | Mental Health Counselor | MH5134 | FL |
N | 101YP2500X | Professional Counselor | MH5134 | FL |
NPI | 1003857541 |
---|---|
Provider Name | Ms. Valerie Angelica Fisher |
First Address | Bradenton, FL 34211-9388 |
Second Address | Sarasota, FL 34236-7718 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 08/07/2007 |