Provider Demographics
NPI:1902195332
Name:KHALSA, BIBI BHANI KAUR
Entity Type:Individual
Prefix:MRS
First Name:BIBI BHANI
Middle Name:KAUR
Last Name:KHALSA
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 1:2245 N RICHLAND ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-1618
Mailing Address - Country:US
Mailing Address - Phone:602-326-5135
Mailing Address - Fax:
Practice Address - Street 1:2245 N RICHLAND ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-1618
Practice Address - Country:US
Practice Address - Phone:623-772-2290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-06
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ71252355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant