Provider Demographics
NPI:1174050744
Name:ASJAD, TAHSIN
Entity type:Individual
Prefix:
First Name:TAHSIN
Middle Name:
Last Name:ASJAD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30801 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48082-1732
Mailing Address - Country:US
Mailing Address - Phone:586-293-1234
Mailing Address - Fax:586-275-7989
Practice Address - Street 1:30801 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48082-1732
Practice Address - Country:US
Practice Address - Phone:586-293-1234
Practice Address - Fax:586-275-7989
Is Sole Proprietor?:No
Enumeration Date:2017-05-15
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician