Provider Demographics
NPI:1033989041
Name:KHALID, SABAH
Entity Type:Individual
Prefix:MS
First Name:SABAH
Middle Name:
Last Name:KHALID
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 1:120 BUTTONWOOD CT
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-3873
Mailing Address - Country:US
Mailing Address - Phone:443-365-4693
Mailing Address - Fax:
Practice Address - Street 1:14815 MANOR RD
Practice Address - Street 2:
Practice Address - City:MONKTON
Practice Address - State:MD
Practice Address - Zip Code:21111-2400
Practice Address - Country:US
Practice Address - Phone:410-205-5123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP14498101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health