Doctor Name: | DR. JUDY LYNNE FISH |
NPI Number: | 1114901295 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSYD |
License Number: | PSY002725 |
Business Practice Address: | 14 Eastbrook Bend Suite 204 Peachtree City, GA - 30269 |
Business Phone Number: | 6783900455 |
Business Fax Number: | |
Mailing Address: | 14 Eastbrook Bnd, Suite 204 PEACHTREE CITY |
State: | GA |
Postal Code: | 302691530 |
Phone Number: | 6783900455 |
Fax Number: | |
NPI Enumeration Date: | 12/02/2005 |
NPI Last Update Date: | 02/04/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PSY002725 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |