Individual
BRENDA FISHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
240 GLEN COVE RD, GLEN HEAD, NY 11545-2207
(516) 659-4891
Mailing address
3000 ROYAL CT UNIT 3104, NORTH HILLS, NY 11040-2633
(516) 692-5203
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
013088-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
013088-1
LICENSE NUMBER
NY
Enumeration date
08/28/2019
Last updated
08/28/2019
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