Individual
AMIR JASSANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
12300 MCCRACKEN RD, GARFIELD HEIGHTS, OH 44125-2914
(216) 587-8350
(216) 587-8646
Mailing address
12300 MCCRACKEN RD, GARFIELD HEIGHTS, OH 44125-2914
(216) 587-8350
(216) 587-8646
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
4756
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000216093
ANTHEM PIN
OH
05
—
2626180
—
OH
01
—
351618
WELLCARE HEALTH PLAN
OH
01
—
740995
BUCKEYE HEALTH PLAN
OH
01
—
7705135
AETNA
OH
01
—
T04756
SUMMACARE HEALTH PLAN
OH
Enumeration date
07/18/2006
Last updated
08/31/2009
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