Provider Demographics
NPI:1821833781
Name:KHABBAZ, CE'ZANNE AHMYE (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:CE'ZANNE
Middle Name:AHMYE
Last Name:KHABBAZ
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:CE'ZANNE
Other - Middle Name:
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12581 MILSTEAD WAY STE 302
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-5446
Mailing Address - Country:US
Mailing Address - Phone:760-221-0701
Mailing Address - Fax:
Practice Address - Street 1:12581 MILSTEAD WAY STE 302
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-5446
Practice Address - Country:US
Practice Address - Phone:760-221-0701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist