Individual
GREGORY FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CCDC-II
Contact information
Practice address
11 4TH ST E, LEMMON, SD 57638-1524
(605) 374-3862
(605) 374-3864
Mailing address
PO BOX 447, 11 EAST 4TH STREET, LEMMON, SD 57638-0447
(605) 374-3862
(605) 374-3864
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05121252
CERT. #
SD
Enumeration date
12/28/2006
Last updated
07/08/2007
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