Provider Demographics
NPI:1073163325
Name:ASAY, LEVI (AUD BC-HIS)
Entity Type:Individual
Prefix:
First Name:LEVI
Middle Name:
Last Name:ASAY
Suffix:
Gender:M
Credentials:AUD BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1535 BLEISTEIN AVE
Mailing Address - Street 2:
Mailing Address - City:CODY
Mailing Address - State:WY
Mailing Address - Zip Code:82414-3806
Mailing Address - Country:US
Mailing Address - Phone:307-527-6475
Mailing Address - Fax:307-527-6483
Practice Address - Street 1:1535 BLEISTEIN AVE
Practice Address - Street 2:
Practice Address - City:CODY
Practice Address - State:WY
Practice Address - Zip Code:82414-3806
Practice Address - Country:US
Practice Address - Phone:307-527-6475
Practice Address - Fax:307-527-6483
Is Sole Proprietor?:No
Enumeration Date:2019-09-18
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY209237700000X
WYA-1051231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WYA-1051OtherWY LICENSE
14287339OtherASHA
8272OtherNBC-HIS
WY209OtherWY LICENSE