Provider Demographics
NPI:1497192496
Name:KHAWAJA, AMNA
Entity Type:Individual
Prefix:
First Name:AMNA
Middle Name:
Last Name:KHAWAJA
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 1:9258 W RUSSELL RD UNIT 204
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-1283
Mailing Address - Country:US
Mailing Address - Phone:702-845-3696
Mailing Address - Fax:
Practice Address - Street 1:9258 W RUSSELL RD UNIT 204
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-1283
Practice Address - Country:US
Practice Address - Phone:702-845-3696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-30
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor