Provider Demographics
NPI:1689185639
Name:JOSEPH, KHALILAH A (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KHALILAH
Middle Name:A
Last Name:JOSEPH
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 1:6150 ALMA RD APT 2442
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-7338
Mailing Address - Country:US
Mailing Address - Phone:214-430-0801
Mailing Address - Fax:
Practice Address - Street 1:680 N WATTERS RD APT 452
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-5126
Practice Address - Country:US
Practice Address - Phone:469-656-9015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-17
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105319235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist