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General NPI Number Information
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NPI Number | 1104263235
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Entity Type | Organization
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Legal Business Name | NORA ALKHATIB
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Dates
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Enumeration Date | 05/30/2013
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Last Update Date | 05/30/2013
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Provider Practice Location Address
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Address Line | 45 LONDONDERRY DR
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City | PALM COAST
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State | FL
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Zip | 32137-9716
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Country | US
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Telephone | 386-864-0181
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Fax |
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Provider Business Mailing Address
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Address Line | 45 LONDONDERRY DR
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City | PALM COAST
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State | FL
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Zip | 32137-9716
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Country | US
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Telephone | 386-864-0181
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH COUNSELOR, M.A.
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Name | NORA ALKHATIB
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Credential |
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Telephone | 386-864-0181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 101YM0800X
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License Number State | FL
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