Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 30788 | TX |
NPI | 1013570860 |
---|---|
Provider Name | Dr. Asra Khan |
First Address | Richardson, TX 75081-5578 |
Second Address | Richardson, TX 75081-5578 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2019 |
Last Update Date | 17/04/2019 |