Daphne Ferriera Fisher

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Gulfport, MS

NPI 1467479477 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1467479477
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
Practice address
1600 Broad Ave
Gulfport, MS 39501-3603
Phone
(228) 863-1132
Fax
(228) 865-1700
NPI assigned
Jul 16, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Yes

Addresses

Primary practice location

1600 Broad Ave
Gulfport, MS 39501-3603

Mailing address

1600 Broad Ave
Gulfport, MS 39501-3603
Phone (228) 863-1132

Other identifiers

IdentifierTypeStateIssuer
00018213MedicaidMS

Other providers in Gulfport, MS

All providers in Gulfport, MS · Addiction (Substance Use Disorder) Counselor in Mississippi

Sources for this page

Verify at the official NPI Registry.