Provider Demographics
NPI:1184627853
Name:COLBERT, CAROL S (PHD)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:S
Last Name:COLBERT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MRS
Other - First Name:CAROL
Other - Middle Name:S
Other - Last Name:SHULMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYCHOLOGIST
Mailing Address - Street 1:6009 LANDERHAVEN DR
Mailing Address - Street 2:STE F
Mailing Address - City:MAYFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124-4192
Mailing Address - Country:US
Mailing Address - Phone:440-461-1010
Mailing Address - Fax:440-542-9986
Practice Address - Street 1:6009 LANDERHAVEN DR
Practice Address - Street 2:STE F
Practice Address - City:MAYFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44124-4192
Practice Address - Country:US
Practice Address - Phone:440-461-1010
Practice Address - Fax:440-542-9986
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1227174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist