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Individual

MRS. CRYSTAL SHERREE JUANITA FISHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BA

Contact information

Practice address
1725 MT HIGHWAY 35, KALISPELL, MT 59901-2464
(406) 549-6141
Mailing address
3335 LT MOSS RD, MISSOULA, MT 59804-7222
(406) 549-6141

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
PSY-ABA-LIC-2594
MT
103K00000X
Behavior Analyst
Primary
PSY-BA-LIC-3626
MT

Other

Enumeration date
12/19/2018
Last updated
10/11/2021
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