| NPI | 1225510282 |
|---|---|
| Former Name | GERARD EDWARD FISHER |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW15637) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 121072) |
| Enumeration Date | 2018-09-05 |
| Last Update Date | 2025-08-08 |