Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 178 | TX |
N | 101YM0800X | Mental Health Counselor | ||
N | 101YP1600X | Pastoral Counselor | ||
N | 101YP2500X | Professional Counselor | 13025 | TX |
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist | ||
N | 102L00000X | Psychologist | CERTIFICATION | TX |
N | 103T00000X | Psychologist | CERTIFICATION | TX |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 5660 | TX |
N | 103TF0200X | Forensic Psychologist | ||
N | 103TP2701X | Group Psychotherapist |
NPI | 1174619357 |
---|---|
Provider Name | Blanche Handunge Khan |
First Address | Houston, TX 77038 |
Second Address | Houston, TX 77098 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10008730 | AMERIGROUP (01) |