Provider Demographics
NPI:1619024726
Name:FIORE, CAROL ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:ANN
Last Name:FIORE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:CAROL
Other - Middle Name:ANN
Other - Last Name:FIORE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:3371 W FOXES DEN DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-5107
Mailing Address - Country:US
Mailing Address - Phone:520-622-7457
Mailing Address - Fax:520-529-8380
Practice Address - Street 1:3371 W FOXES DEN DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-5107
Practice Address - Country:US
Practice Address - Phone:520-622-7457
Practice Address - Fax:520-529-8380
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2009-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3416103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ67904Medicare ID - Type Unspecified
AZ667904Medicare UPIN