Provider Demographics
NPI:1427715382
Name:FISHER, ADRIONNA
Entity type:Individual
Prefix:
First Name:ADRIONNA
Middle Name:
Last Name:FISHER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4223 WARNER ST
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-4059
Mailing Address - Country:US
Mailing Address - Phone:808-265-0558
Mailing Address - Fax:
Practice Address - Street 1:4223 WARNER ST
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-4059
Practice Address - Country:US
Practice Address - Phone:808-265-0558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-25
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
UT103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician