Provider Demographics
NPI:1386304590
Name:KHAN, MADEEHA M
Entity type:Individual
Prefix:
First Name:MADEEHA
Middle Name:M
Last Name:KHAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 SUGARBERRY DR
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-7629
Mailing Address - Country:US
Mailing Address - Phone:302-650-7931
Mailing Address - Fax:
Practice Address - Street 1:6 DENNY RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19809-3444
Practice Address - Country:US
Practice Address - Phone:302-543-5089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-29
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor