Individual
KHALILAH DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9110 N LOOP 1604 W STE 104, SAN ANTONIO, TX 78249-3397
(210) 396-8472
Mailing address
9110 N LOOP 1604 W STE 104, SAN ANTONIO, TX 78249-3397
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
01/21/2025
Last updated
01/21/2025
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