Provider Demographics
NPI:1497165138
Name:KHAUKHA, KEAIRA RENEE (OTR/L)
Entity Type:Individual
Prefix:
First Name:KEAIRA
Middle Name:RENEE
Last Name:KHAUKHA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6681 SORENSEN PKWY
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68152-2139
Mailing Address - Country:US
Mailing Address - Phone:402-932-8884
Mailing Address - Fax:402-932-8885
Practice Address - Street 1:5208 TIMBERRIDGE DR
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68133-2759
Practice Address - Country:US
Practice Address - Phone:816-859-0839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-03
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2767225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist