Individual
ASHLEY KHATRI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.,CCC-SLP
Contact information
Practice address
300 TWINING ST, 42D MEDICAL GROUP-MENTAL HEALTH CLINIC, MAXWELL AFB, AL 36112-6027
(334) 953-4415
Mailing address
300 S. TWINING STREET, BLDG 760, 42D MEDICAL GROUP-MENTAL HEALTH CLINIC, MAXWELL AFB, AL 36112-6219
(334) 953-4415
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA 8708
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890469300
—
FL
Enumeration date
06/04/2006
Last updated
03/15/2018
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