Individual
MRS. LAURA MARY FISHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
19215 PENINSULA SHORES DR, CORNELIUS, NC 28031-7579
(703) 501-6366
Mailing address
300 SUTRO FOREST DR NW, CONCORD, NC 28027-8095
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
7008
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0560
CIGNA
—
01
—
12442285
CAQH
—
01
—
175CM
BCBS
NC
01
—
187840
BLUE CROSS BLUE SHIELD
VA
01
—
314668
AMERIGROUP
VA
05
—
7302425
—
NC
01
—
853461
OPTUMHEALTH
—
Enumeration date
02/05/2007
Last updated
07/16/2013
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