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Individual

DIANE FISHER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
1830 SHERMAN AVE, SUITE 204, EVANSTON, IL 60201-3771
(847) 989-1745
(847) 920-9276
Mailing address
1830 SHERMAN AVE, SUITE 204, EVANSTON, IL 60201-3771
(847) 989-1745
(847) 920-9276

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071.006707
IL
314000000X
Skilled Nursing Facility
071006707
IL

Other

Enumeration date
03/18/2008
Last updated
02/23/2009
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