Provider Information for 1558023531
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ASLI BAZ PsyD
Sex: Female
NPI: 1558023531
Last Updated: 2021-10-07
Certification Date: 2021-10-07
Certification Date: 2021-10-07
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1558023531 | ||||||||
| Enumeration Date | 2021-10-07 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 16315 WAGNER WAY APT 210E EDEN PRAIRIE, MN 55344-5735 United States Phone: 312-684-8620 | Fax: | ||||||||
| Primary Practice Address | 16315 WAGNER WAY APT 210E EDEN PRAIRIE, MN 55344-5735 United States Phone: 312-684-8620 | Fax: | ||||||||
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