Individual
MARTHA FISKEAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10000 BAY PINES BLVD, BAY PINES, FL 33744-8200
(727) 398-6661
Mailing address
3435 N DRUID HILLS RD APT L, DECATUR, GA 30033-3758
(813) 838-2226
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY004788
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
09/07/2021
Last updated
06/25/2024
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