MEDICARE: DR. ASIAH MASON PH.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PS007376L	PA
2	103TC0700X	Clinical Psychologist	07032	MD

General Provider Information

NPI Number	:	1871354571
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ASIAH MASON PH.D

Provider Business Mailing Address
First Line	:	12007 YELLOWBELL LN
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21044-4502
Country	:	US
Telephone Number	:	202-904-4194
Fax Number	:

Provider Business Practice Location Address
First Line	:	12007 YELLOWBELL LN
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21044-4502
Country	:	US
Telephone Number	:	202-904-4194
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2024
Last Update Date	:	01/19/2024

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Directions to “ DR. ASIAH MASON PH.D” Practice Location

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