Individual
KATHLEEN FISHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW, LPC, ACS
Contact information
Practice address
530 MAIN AVE, PASSAIC, NJ 07055-5700
(973) 470-3168
Mailing address
530 MAIN AVE, PASSAIC, NJ 07055-5700
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
37PC00167800
NJ
104100000X
Social Worker
44SL00110500
NJ
Other
Enumeration date
10/16/2013
Last updated
10/16/2013
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