Individual
DEANDRA FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED., M.S. CCC-SLP
Contact information
Practice address
4000 BLUE RIDGE BLVD, DALLAS, TX 75233-2438
(972) 794-5910
Mailing address
4000 BLUE RIDGE BLVD, DALLAS, TX 75233-2438
(972) 794-5910
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
107063
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120085901
—
TX
Enumeration date
11/29/2022
Last updated
07/14/2023
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