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Individual

MRS. ILENE FISHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
711 PLUMMER DR, GREENSBORO, NC 27410-4443
(336) 256-0046
Mailing address
711 PLUMMER DR, GREENSBORO, NC 27410-4443

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5396
NC
103TC2200X
Clinical Child & Adolescent Psychologist
5396
NC

Other

Enumeration date
05/10/2008
Last updated
05/10/2008
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