Provider Demographics
NPI:1760562896
Name:AZIMI, AMIN (EDD)
Entity Type:Individual
Prefix:DR
First Name:AMIN
Middle Name:
Last Name:AZIMI
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 24TH AVE N STE 200
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1520
Mailing Address - Country:US
Mailing Address - Phone:615-327-2978
Mailing Address - Fax:615-327-9235
Practice Address - Street 1:345 24TH AVE N STE 200
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1520
Practice Address - Country:US
Practice Address - Phone:615-327-2978
Practice Address - Fax:615-327-9235
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1431103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling