Provider Demographics
NPI:1730396607
Name:FISHER, ARETHA LYNN (PSYD)
Entity type:Individual
Prefix:DR
First Name:ARETHA
Middle Name:LYNN
Last Name:FISHER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4130 ELLINGER DR
Mailing Address - Street 2:
Mailing Address - City:HEATH
Mailing Address - State:TX
Mailing Address - Zip Code:75126-3721
Mailing Address - Country:US
Mailing Address - Phone:510-332-5042
Mailing Address - Fax:
Practice Address - Street 1:4130 ELLINGER DR
Practice Address - Street 2:
Practice Address - City:HEATH
Practice Address - State:TX
Practice Address - Zip Code:75126-3721
Practice Address - Country:US
Practice Address - Phone:510-332-5042
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34807103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical