Provider Demographics
NPI:1982440053
Name:FISHER, CINDY L (CDCA PRE)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:L
Last Name:FISHER
Suffix:
Gender:F
Credentials:CDCA PRE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2630 CRESTWELL PL
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45420-3735
Mailing Address - Country:US
Mailing Address - Phone:937-397-8333
Mailing Address - Fax:
Practice Address - Street 1:2630 CRESTWELL PL
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45420-3735
Practice Address - Country:US
Practice Address - Phone:937-397-8333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)