Provider Information for 1699051326
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KELLY ANN FISHER LCSW
Sex: Female
NPI: 1699051326
Last Updated: 2021-03-16
Certification Date: 2021-03-16
Certification Date: 2021-03-16
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1699051326 | ||||||||||||
| Enumeration Date | 2011-10-26 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 30 AMETHYST DR QUEENSBURY, NY 12804-9498 United States Phone: 518-222-9977 | Fax: | ||||||||||||
| Primary Practice Address | 173 LAKE HILL RD BURNT HILLS, NY 12027-9405 United States Phone: 518-399-9141 | Fax: | ||||||||||||
| Secondary Practice Address(es) | 11 HASWELL ROAD | ||||||||||||
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