Provider Demographics
NPI:1255302857
Name:WOCHENKO, CAROL JANE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:JANE
Last Name:WOCHENKO
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 1:33 W WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45056-1747
Mailing Address - Country:US
Mailing Address - Phone:513-523-1966
Mailing Address - Fax:
Practice Address - Street 1:33 W WALNUT ST
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:OH
Practice Address - Zip Code:45056-1747
Practice Address - Country:US
Practice Address - Phone:513-523-1966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-31
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5994103TC0700X
KY1320103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical