Individual
MARY BETH E FISHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4010 W 59TH ST, FAIRWAY, KS 66205-3101
(913) 722-0117
Mailing address
4010 W 59TH ST, FAIRWAY, KS 66205-3101
(913) 722-0117
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
1525
KS
1041C0700X
Clinical Social Worker
Primary
2010040968
MO
Other
Enumeration date
04/19/2011
Last updated
04/19/2011
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