Individual
GWENDOLYN FISHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6345 CENTER DR, NORFOLK, VA 23502-4126
(757) 467-8184
Mailing address
934 NORCHESTER AVE, NORFOLK, VA 23504-4012
(757) 651-6128
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701010919
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447345145
—
VA
Enumeration date
10/29/2021
Last updated
10/29/2021
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