Individual
MR. WAIS IBRAHIM KHAIRANDESH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
3502 W CAMELBACK RD, PHOENIX, AZ 85019-2707
(480) 308-5478
Mailing address
3502 W CAMELBACK RD, PHOENIX, AZ 85019-2707
(480) 308-5478
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
CMH0194921
NM
101YP2500X
Professional Counselor
Primary
LPC-21128
AZ
Other
Enumeration date
04/25/2018
Last updated
12/05/2022
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