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Individual

SUSAN FISHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
1400 EMELINE AVE, SANTA CRUZ, CA 95060-1976
(831) 454-4107
(831) 454-4663
Mailing address
1400 EMELINE AVE, SANTA CRUZ, CA 95060-1976
(831) 454-4107
(831) 454-4663

Taxonomy

Speciality
Code
Description
License number
State
225XM0800X
Mental Health Occupational Therapist
Primary
4939
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4939
PROFESSIONAL LICENSE #
CA
05
FHC70042F
CA
05
FHC70044F
CA
Enumeration date
04/30/2010
Last updated
10/25/2017
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