Individual
DR. HUMAMA KHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
202 MISTY GROVE DR, LOGANVILLE, GA 30052-9054
(770) 331-4882
Mailing address
202 MISTY GROVE DR, LOGANVILLE, GA 30052-9054
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY004586
GA
103TC2200X
Clinical Child & Adolescent Psychologist
PSY00486
GA
Other
Enumeration date
10/31/2022
Last updated
10/31/2022
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