Doctor Name: | MS. KHATIMA SHAH |
NPI Number: | 1215108014 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 074145-1 |
Business Practice Address: | 13359 116th St South Ozone Park, NY - 114203112 |
Business Phone Number: | 9177147248 |
Business Fax Number: | 7188485952 |
Mailing Address: | 13359 116th St, SOUTH OZONE PARK |
State: | NY |
Postal Code: | 114203112 |
Phone Number: | 9177147248 |
Fax Number: | 7188485952 |
NPI Enumeration Date: | 03/19/2008 |
NPI Last Update Date: | 03/19/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 074145-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |