Provider Demographics
NPI:1104263235
Name:NORA ALKHATIB
Entity type:Organization
Organization Name:NORA ALKHATIB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR, M.A.
Authorized Official - Prefix:
Authorized Official - First Name:NORA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALKHATIB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-864-0181
Mailing Address - Street 1:45 LONDONDERRY DR
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-9716
Mailing Address - Country:US
Mailing Address - Phone:386-864-0181
Mailing Address - Fax:
Practice Address - Street 1:45 LONDONDERRY DR
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-9716
Practice Address - Country:US
Practice Address - Phone:386-864-0181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-30
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101YM0800X252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency