Provider Demographics
NPI:1033846852
Name:EVANS, AISHA (PSYD)
Entity Type:Individual
Prefix:
First Name:AISHA
Middle Name:
Last Name:EVANS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MAIL BOX 0034
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45221-0034
Mailing Address - Country:US
Mailing Address - Phone:513-556-0648
Mailing Address - Fax:513-556-2302
Practice Address - Street 1:225 CALHOUN STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:CINCINNATTI
Practice Address - State:OH
Practice Address - Zip Code:45219
Practice Address - Country:US
Practice Address - Phone:513-556-0648
Practice Address - Fax:513-556-0648
Is Sole Proprietor?:No
Enumeration Date:2022-08-02
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHP.08241103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist