Healthcare Provider Details

I. General information

NPI: 1073392973
Provider Name (Legal Business Name): SANJEETA KHALID
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2023
Last Update Date: 09/28/2023
Certification Date: 09/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1951 NW 7TH AVE FL 3
MIAMI FL
33136-1104
US

IV. Provider business mailing address

1951 NW 7TH AVE FL 3
MIAMI FL
33136-1104
US

V. Phone/Fax

Practice location:
  • Phone: 305-902-6347
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: