Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 104100000X | Social Worker | 070210 | NY |
Y | 1041C0700X | Clinical Social Worker | 086359 | NY |
NPI | 1003354747 |
---|---|
Provider Name | Lama Z. Khouri |
First Address | New York, NY 10016-7381 |
Second Address | New York, NY 10016-7381 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2017 |
Last Update Date | 13/08/2021 |