Basic Information
| Provider Information | |||||||||
| NPI: | 1861605347 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FISHER | ||||||||
| FirstName: | JUNE | ||||||||
| MiddleName: | RITCHEY | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LMFT | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | RITCHEY | ||||||||
| OtherFirstName: | JUNE | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | MRS. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | LMFT | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 13403 MEYER RD | ||||||||
| Address2: | |||||||||
| City: | MABELVALE | ||||||||
| State: | AR | ||||||||
| PostalCode: | 721032607 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5014554979 | ||||||||
| FaxNumber: | 5014552571 | ||||||||
| Practice Location | |||||||||
| Address1: | 20400 COLONEL GLENN RD | ||||||||
| Address2: | |||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722105323 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5018215500 | ||||||||
| FaxNumber: | 5018215582 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/08/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | M9802005 | AR | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.