Provider Demographics
NPI:1730822982
Name:FISHER, BRANDY (MA)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:
Last Name:FISHER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 OLD TRENTON RD APT 1002
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-2313
Mailing Address - Country:US
Mailing Address - Phone:304-904-0902
Mailing Address - Fax:
Practice Address - Street 1:1300 HATCHER LN
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-3554
Practice Address - Country:US
Practice Address - Phone:931-548-3177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-15
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)