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Individual

AWARISH KHAWAJA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
210 PRITCHARD DR, PALM COAST, FL 32164-7103
(718) 687-2951
Mailing address
210 PRITCHARD DR, PALM COAST, FL 32164-7103
(718) 687-2951

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
008745-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
008745-1
NEW YORK STATE EDUCATION DEPARTMENT, DIVISION OF PROFESSIONAL LICENSING SERVICES
NY
Enumeration date
08/26/2015
Last updated
08/26/2015
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