| Doctor Name: | DAVID JAMES FISH |
| NPI Number: | 1043614530 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LMSW |
| License Number: | 6301071297 |
| Business Practice Address: | 27941 Harper Ave Ste 102 Saint Clair Shores, MI - 480811535 |
| Business Phone Number: | 5864845290 |
| Business Fax Number: | |
| Mailing Address: | 30524 Mcgrath Dr, WARREN |
| State: | MI |
| Postal Code: | 480935611 |
| Phone Number: | 5864845290 |
| Fax Number: | |
| NPI Enumeration Date: | 10/13/2014 |
| NPI Last Update Date: | 10/13/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041S0200X |
| License Number: | 6301071297 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |