Provider Demographics
NPI:1770158081
Name:WILLIFORD, DESIREE NICOLE (PHD)
Entity type:Individual
Prefix:DR
First Name:DESIREE
Middle Name:NICOLE
Last Name:WILLIFORD
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 1:2800 WINSLOW AVE
Mailing Address - Street 2:ML 6024
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45206-1144
Mailing Address - Country:US
Mailing Address - Phone:513-636-4336
Mailing Address - Fax:
Practice Address - Street 1:2800 WINSLOW AVE
Practice Address - Street 2:ML 6024
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45206-1144
Practice Address - Country:US
Practice Address - Phone:513-636-4336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-20
Last Update Date:2025-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHP.08869103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist