| Doctor Name: | MR. CLAY CONRAD KHIN |
| NPI Number: | 1790110864 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | SLPA8155 |
| Business Practice Address: | 4810 E Beaver Creek Rd Rimrock, AZ - 863356241 |
| Business Phone Number: | 9285674631 |
| Business Fax Number: | |
| Mailing Address: | Po Box 666, CLARKDALE |
| State: | AZ |
| Postal Code: | 863240666 |
| Phone Number: | 9288620612 |
| Fax Number: | |
| NPI Enumeration Date: | 09/09/2013 |
| NPI Last Update Date: | 09/09/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2355S0801X |
| License Number: | SLPA8155 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Specialist/Technologist |
| Taxonomy Specialization: | Speech-Language Assistant |
| Taxonomy Definition: | |