Healthcare Provider Details

I. General information

NPI: 1871429670
Provider Name (Legal Business Name): TALEA KHWAJA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2712 CHAMBERLAYNE AVE
RICHMOND VA
23222-3504
US

IV. Provider business mailing address

9343 JANEWAY DR
MECHANICSVILLE VA
23116-2637
US

V. Phone/Fax

Practice location:
  • Phone: 804-599-3288
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: