Provider Demographics
NPI:1871737395
Name:FISCHBACH, CATHLEEN ELIZABETH (MS, CCC-SLP)
Entity type:Individual
Prefix:MISS
First Name:CATHLEEN
Middle Name:ELIZABETH
Last Name:FISCHBACH
Suffix:
Gender:F
Credentials:MS, CCC-SLP
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Mailing Address - Street 1:664 DEGRAW STREET
Mailing Address - Street 2:#1
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214
Mailing Address - Country:US
Mailing Address - Phone:917-318-0086
Mailing Address - Fax:212-255-6279
Practice Address - Street 1:664 DEGRAW ST # 1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-3113
Practice Address - Country:US
Practice Address - Phone:917-318-0086
Practice Address - Fax:212-255-6279
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-28
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY015575-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist