Individual
KIA FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2658 FARMSTEAD CT, GRAYSON, GA 30017-4289
(770) 298-6322
Mailing address
2658 FARMSTEAD CT, GRAYSON, GA 30017-4289
(770) 298-6322
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15050209
CAQH
GA
Enumeration date
12/28/2020
Last updated
12/28/2020
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