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Individual

MARZI LISA RADPOUR-WILEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
6401 SHALLOWFORD RD, CHATTANOOGA, TN 37421-5406
(423) 893-6500
Mailing address
6401 SHALLOWFORD RD, CHATTANOOGA, TN 37421-5406
(423) 893-6500

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
P2532
TN
1041C0700X
Clinical Social Worker
LSW03734
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3926524
TN
Enumeration date
10/06/2005
Last updated
09/14/2023
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