Provider Demographics
NPI:1215082326
Name:FISCHER, ROSEMARIE (SLP)
Entity type:Individual
Prefix:
First Name:ROSEMARIE
Middle Name:
Last Name:FISCHER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:242 AVALON HILLS DR
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MO
Mailing Address - Zip Code:63026-2696
Mailing Address - Country:US
Mailing Address - Phone:314-753-7385
Mailing Address - Fax:636-861-0533
Practice Address - Street 1:242 AVALON HILLS DR
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MO
Practice Address - Zip Code:63026-2696
Practice Address - Country:US
Practice Address - Phone:314-753-7385
Practice Address - Fax:636-861-0533
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2011-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO101689235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist