Provider Demographics
NPI:1871354571
Name:MASON, ASIAH (PHD)
Entity type:Individual
Prefix:DR
First Name:ASIAH
Middle Name:
Last Name:MASON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12007 YELLOWBELL LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-4502
Mailing Address - Country:US
Mailing Address - Phone:202-904-4194
Mailing Address - Fax:
Practice Address - Street 1:12007 YELLOWBELL LN
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-4502
Practice Address - Country:US
Practice Address - Phone:202-904-4194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-19
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS007376L103TC0700X
MD07032103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical