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General NPI Number Information
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NPI Number | 1346833787
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Entity Type | Individual
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Provider Name | MOHAMMAD A KHAN LLMSW
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Gender | Male
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Dates
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Enumeration Date | 02/17/2021
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Last Update Date | 02/17/2021
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Provider Practice Location Address
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Address Line | 20600 EUREKA RD STE 707
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City | TAYLOR
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State | MI
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Zip | 48180-5376
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Country | US
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Telephone | 734-925-4140
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Fax | 734-519-5517
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Provider Business Mailing Address
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Address Line | 19109 PINE LEDGE DR
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City | BROWNSTOWN
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State | MI
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Zip | 48193-7588
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Country | US
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Telephone | 734-925-4140
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Fax | 734-519-5517
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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