Provider Demographics
NPI:1972807980
Name:FISHER, RONALD JOSEPH
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:JOSEPH
Last Name:FISHER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7614 NW TONBRIDGE PL
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-4005
Mailing Address - Country:US
Mailing Address - Phone:580-536-9755
Mailing Address - Fax:580-351-9898
Practice Address - Street 1:7614 NW TONBRIDGE PL
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-4005
Practice Address - Country:US
Practice Address - Phone:580-536-9755
Practice Address - Fax:580-351-9898
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst