| NPI | 1780676924 |
|---|---|
| Former Name | JANIS LYNN FISKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCS20326) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OR 1609) |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2007-07-13 |