Provider Demographics
NPI:1285968552
Name:FISCHER, SUZAN MARIE (LLP)
Entity type:Individual
Prefix:MRS
First Name:SUZAN
Middle Name:MARIE
Last Name:FISCHER
Suffix:
Gender:F
Credentials:LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 N WALNUT ST STE 201
Mailing Address - Street 2:
Mailing Address - City:MOUNT CLEMENS
Mailing Address - State:MI
Mailing Address - Zip Code:48043-5652
Mailing Address - Country:US
Mailing Address - Phone:586-764-8867
Mailing Address - Fax:586-466-5961
Practice Address - Street 1:59 N WALNUT ST STE 201
Practice Address - Street 2:
Practice Address - City:MOUNT CLEMENS
Practice Address - State:MI
Practice Address - Zip Code:48043-5652
Practice Address - Country:US
Practice Address - Phone:586-764-8867
Practice Address - Fax:586-466-5961
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-19
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401007924106H00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist