Provider Demographics
NPI:1346646023
Name:KHALATYAN, GOHAR (MA, BCBA)
Entity Type:Individual
Prefix:
First Name:GOHAR
Middle Name:
Last Name:KHALATYAN
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17037 CHATSWORTH ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-5825
Mailing Address - Country:US
Mailing Address - Phone:818-937-0882
Mailing Address - Fax:818-937-0883
Practice Address - Street 1:17037 CHATSWORTH ST
Practice Address - Street 2:SUITE 206
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-5825
Practice Address - Country:US
Practice Address - Phone:818-937-0882
Practice Address - Fax:818-937-0883
Is Sole Proprietor?:No
Enumeration Date:2014-11-07
Last Update Date:2014-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-14-9884103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst