Individual
SIDRAH AMHED KHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1351 WISCONSIN RIVER DR, PORT EDWARDS, WI 54469-1099
(715) 885-8333
Mailing address
1425 N 12TH AVE APT 310, WAUSAU, WI 54401-2457
(201) 281-9672
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5104-154
WI
Other
Enumeration date
10/12/2020
Last updated
10/12/2020
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