Healthcare Provider Details

I. General information

NPI: 1376358564
Provider Name (Legal Business Name): MARISA CAHALL PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2025
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1670 FISHINGER RD STE 200
UPPER ARLINGTON OH
43221-1446
US

IV. Provider business mailing address

1670 FISHINGER RD STE 200
UPPER ARLINGTON OH
43221-1446
US

V. Phone/Fax

Practice location:
  • Phone: 614-456-2540
  • Fax: 614-633-3675
Mailing address:
  • Phone: 614-456-2540
  • Fax: 614-633-3675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberP.08750
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: