Individual
ALISHA JEANNINE MASSEN FISHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
237 26TH ST, OGDEN, UT 84401-3105
(801) 625-3700
Mailing address
237 26TH ST, OGDEN, UT 84401-3105
(801) 625-3700
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
Primary
10434952-3503
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
260022408
RAILROAD MEDICARE
UT
05
—
876000308007
—
UT
Enumeration date
11/18/2015
Last updated
05/07/2018
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