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Individual

SOPHIA FISHER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
16823 NE 116TH ST, LIBERTY, MO 64068-8278
(816) 668-5586
Mailing address
16823 NE 116TH ST, LIBERTY, MO 64068-8278
(816) 668-5586

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary

Other

Enumeration date
10/26/2016
Last updated
10/26/2016
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