Provider Demographics
NPI:1437708997
Name:AL-KHASHTI, LAILA (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LAILA
Middle Name:
Last Name:AL-KHASHTI
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 TEN ROD RD STE F101
Mailing Address - Street 2:
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-4170
Mailing Address - Country:US
Mailing Address - Phone:401-295-2955
Mailing Address - Fax:
Practice Address - Street 1:1130 TEN ROD RD STE F101
Practice Address - Street 2:
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-4170
Practice Address - Country:US
Practice Address - Phone:401-295-2955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-08
Last Update Date:2019-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RISP01487235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist