Provider Demographics
NPI:1255196069
Name:SULUKI, KHAYRIYYAH N
Entity type:Individual
Prefix:
First Name:KHAYRIYYAH
Middle Name:N
Last Name:SULUKI
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 1:207 CREEL WAY
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30349-4914
Mailing Address - Country:US
Mailing Address - Phone:678-437-2756
Mailing Address - Fax:
Practice Address - Street 1:KEY AUTISM SERVICES
Practice Address - Street 2:1385 HWY 35 #284
Practice Address - City:MIDDLETOWN
Practice Address - State:NJ
Practice Address - Zip Code:07748
Practice Address - Country:US
Practice Address - Phone:857-829-4040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician