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General NPI Number Information
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NPI Number | 1922744291
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Entity Type | Individual
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Provider Name | GRETA J KHANNA PHD
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Gender | Female
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Dates
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Enumeration Date | 05/10/2022
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 450 BROOKLINE AVE # JF7
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City | BOSTON
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State | MA
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Zip | 02215-5450
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Country | US
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Telephone | 857-215-4630
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Fax |
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Provider Business Mailing Address
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Address Line | 125 CHISWICK RD APT 502
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City | BRIGHTON
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State | MA
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Zip | 02135-5308
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Country | US
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Telephone | 732-513-1002
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Fax |
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | PSY10000203
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License Number State | MA
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