MEDICARE: SANNA KHOJA LPC-INTERN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	78266	TX

General Provider Information

NPI Number	:	1306318464
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANNA KHOJA LPC-INTERN

Provider Business Mailing Address
First Line	:	10201 BUFFALO SPEEDWAY APT 1310
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-2544
Country	:	US
Telephone Number	:	409-225-1446
Fax Number	:

Provider Business Practice Location Address
First Line	:	6550 MAPLERIDGE ST STE 210
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77081-4647
Country	:	US
Telephone Number	:	866-357-9461
Fax Number	:	713-665-9100

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2018
Last Update Date	:	12/28/2018

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