MEDICARE: NABILA KHAN

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	106S00000X	Behavior Technician	RBT-22-204041	TX

General Provider Information

NPI Number	:	1629850789
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NABILA KHAN

Provider Business Mailing Address
First Line	:	5700 SEPULVEDA BLVD APT 512
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91411-2964
Country	:	US
Telephone Number	:	504-261-2263
Fax Number	:

Provider Business Practice Location Address
First Line	:	5700 SEPULVEDA BLVD APT 512
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91411-2964
Country	:	US
Telephone Number	:	504-261-2263
Fax Number	:

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

Provider Enumeration Date	:	10/13/2023
Last Update Date	:	10/13/2023

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Directions to “ NABILA KHAN ” Practice Location

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