Provider Demographics
NPI:1356795116
Name:KHAN, HAFSA
Entity type:Individual
Prefix:
First Name:HAFSA
Middle Name:
Last Name:KHAN
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 1:3649 W WALNUT HILL LN
Mailing Address - Street 2:APT 3110
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-4043
Mailing Address - Country:US
Mailing Address - Phone:646-309-8792
Mailing Address - Fax:
Practice Address - Street 1:3649 W WALNUT HILL LN
Practice Address - Street 2:APT 3110
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-4043
Practice Address - Country:US
Practice Address - Phone:646-309-8792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-19
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst