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Individual

MR. ELLIOT A. FISCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
108 N MAIN ST, SOUTH BEND, IN 46601-1625
(574) 234-3515
Mailing address
51558 TEASDALE CT, SOUTH BEND, IN 46637-1360
(574) 247-0609

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34001951A
IN

Other

Enumeration date
12/18/2006
Last updated
07/08/2007
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