Provider Demographics
NPI:1992800684
Name:FISHER, ANN DREHER
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:DREHER
Last Name:FISHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:364 COBB HILL RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:VT
Mailing Address - Zip Code:05443
Mailing Address - Country:US
Mailing Address - Phone:802-453-5517
Mailing Address - Fax:
Practice Address - Street 1:14 SCHOOL STREET
Practice Address - Street 2:SUITE #9
Practice Address - City:BRISTOL
Practice Address - State:VT
Practice Address - Zip Code:05443
Practice Address - Country:US
Practice Address - Phone:802-453-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT000072101YA0400X
VT0470000643103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
699667OtherMVP
N3628625OtherUBH
VT1009660Medicaid
ASH00059379OtherBLUE X