Provider Demographics
NPI:1659919355
Name:KHAWAY, MARY-NYAKOUN K (MA)
Entity Type:Individual
Prefix:
First Name:MARY-NYAKOUN
Middle Name:K
Last Name:KHAWAY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6120 EARLE BROWN DR STE 100
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55430-4100
Mailing Address - Country:US
Mailing Address - Phone:763-277-1020
Mailing Address - Fax:763-537-7162
Practice Address - Street 1:8590 EDINBURGH CENTER DR
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55443-3723
Practice Address - Country:US
Practice Address - Phone:763-425-5959
Practice Address - Fax:763-425-5929
Is Sole Proprietor?:No
Enumeration Date:2019-12-13
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health