Asal Azizi, PSY.D.
Individual provider Active NPI Clinical Psychologist · Marshfield, WI
NPI 1902187040 · NPPES record last updated Feb 17, 2012
Key facts
- NPI
- 1902187040
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 2978-57 (WI)
- Practice address
- 216 E Upham St
Marshfield, WI 54449-1543 - Phone
- (715) 502-4642
- NPI assigned
- Sep 2, 2011
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY24063 | CA | MD | Clinical Psychologist |
| 2978-57 | WI | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY24063 | CA | |
| Clinical Psychologist | 103TC0700X | 2978-57 | WI | Yes |
Addresses
Primary practice location
216 E Upham St
Marshfield, WI 54449-1543
Mailing address
216 E Upham St
Marshfield, WI 54449-1543
Phone (715) 502-4642
Other providers in Marshfield, WI
- Astia Health Clinical Services, SC
- Shahid Ali Atcha
- Kelly S. Aue
- Becky Ault
- Olatilewa Awe
- Lisa S Baasch
- Kimberly K. Badzinski
- Stacy Lea Bailey
- Parth Bajoria
- Christine Bakke
All providers in Marshfield, WI · Clinical Psychologist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 17, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.