| Doctor Name: | SUSAN ELIZABETH FISHER |
| NPI Number: | 1114168762 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | PS016601 |
| Business Practice Address: | 405 W Boxelder Rd Suite A-1 Gillette, WY - 827185320 |
| Business Phone Number: | 3076867779 |
| Business Fax Number: | 3076869494 |
| Mailing Address: | 405 W Boxelder Rd, Suite A-1 GILLETTE |
| State: | WY |
| Postal Code: | 827185320 |
| Phone Number: | 3076867779 |
| Fax Number: | 3076869494 |
| NPI Enumeration Date: | 03/11/2009 |
| NPI Last Update Date: | 05/20/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PS016601 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | PA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |