Individual
MRS. BRENDA SHARALYN FISHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LCAS LPC LPC-S
Contact information
Practice address
4320 SOUTHPORT SUPPLY RD SE, SUITE 300, SOUTHPORT, NC 28461-8158
(910) 964-3352
(910) 842-3351
Mailing address
428 HAMILTON DR SE, BOLIVIA, NC 28422-7716
(910) 964-3352
(910) 842-3351
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4124
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
340955
MHN
NC
Enumeration date
08/09/2005
Last updated
09/09/2014
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