Fisher, Bruce R
Fisher, Bruce R is an individual health care provider with primary practice located at 2550 University Ave W Suite 435 S., Saint Paul MN 55114-1052. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Fisher, Bruce R can be contacted via phone (651) 647-1900.Contact Information
Primary practice address
2550 University Ave W Suite 435 S.
Saint Paul MN 55114-1052
Phone: (651) 647-1900
Fax: (651) 647-1861
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 1634 | Minnesota |
Profile Details
| NPI number | 1235104084 |
|---|---|
| LBN Legal business name | Fisher, Bruce R |
| Credentials | MSW LICSW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 22nd, 2006 |
| Last updated | Jan 27th, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1235104084 | NPPES |
| Minnesota | MEDICAID | 968557000 |
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