| Doctor Name: | KHADIJAH M FAISON |
| NPI Number: | 1023392180 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 3455 W Craig Rd Suite C North Las Vegas, NV - 890325118 |
| Business Phone Number: | 7029820600 |
| Business Fax Number: | 7029820300 |
| Mailing Address: | 3455 W. Craig Road,, Suite C LAS VEGAS |
| State: | NV |
| Postal Code: | 89032 |
| Phone Number: | 7029820600 |
| Fax Number: | 7029820300 |
| NPI Enumeration Date: | 10/06/2011 |
| NPI Last Update Date: | 10/06/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |