Individual
DR. TASNEEM DOCTOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ED.D.
Contact information
Practice address
3305 N 25TH PL, PHOENIX, AZ 85016-7427
(602) 525-4087
Mailing address
5850 ROCKY SHORE DR, LEWIS CENTER, OH 43035-7993
(614) 746-9159
(614) 457-0026
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3924
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
191019
—
AZ
05
—
3810004692
—
WV
Enumeration date
09/25/2006
Last updated
10/27/2017
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