Provider Demographics
NPI:1114431889
Name:MCGRANN, KHOURI E (MSED, BCBA, LBS)
Entity Type:Individual
Prefix:
First Name:KHOURI
Middle Name:E
Last Name:MCGRANN
Suffix:
Gender:F
Credentials:MSED, BCBA, LBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 WALNUT ST FL 2
Mailing Address - Street 2:
Mailing Address - City:JENKINTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19046-2034
Mailing Address - Country:US
Mailing Address - Phone:484-478-1577
Mailing Address - Fax:
Practice Address - Street 1:507 WALNUT ST FL 2
Practice Address - Street 2:
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-2034
Practice Address - Country:US
Practice Address - Phone:484-478-1577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-16
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH003446103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst