Individual
TINA KHALED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17505 OLD JEFFERSON HWY, PRAIRIEVILLE, LA 70769-3930
(985) 500-3130
Mailing address
10328 BROWNING DR, BATON ROUGE, LA 70815-4716
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/18/2020
Last updated
12/18/2020
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