Provider Demographics
NPI:1952843245
Name:FISHER, CAROLYN JEAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:JEAN
Last Name:FISHER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4041 N HIGH ST STE 102B
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3248
Mailing Address - Country:US
Mailing Address - Phone:614-431-1418
Mailing Address - Fax:
Practice Address - Street 1:4041 N HIGH ST STE 102B
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3248
Practice Address - Country:US
Practice Address - Phone:614-431-1418
Practice Address - Fax:614-678-5556
Is Sole Proprietor?:No
Enumeration Date:2016-11-17
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH7556103TH0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth