Provider Demographics
NPI:1053539767
Name:FISCHER, LOIS DIANN NELSON (MA, LMFT)
Entity type:Individual
Prefix:MS
First Name:LOIS
Middle Name:DIANN NELSON
Last Name:FISCHER
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10505 WAYZATA BLVD
Mailing Address - Street 2:SUITE # 200
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55305-1502
Mailing Address - Country:US
Mailing Address - Phone:763-546-5797
Mailing Address - Fax:
Practice Address - Street 1:10505 WAYZATA BLVD
Practice Address - Street 2:SUITE # 200
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-1502
Practice Address - Country:US
Practice Address - Phone:763-546-6797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1499106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist