Provider Demographics
NPI:1407043136
Name:KHAN, YASMEEN (PT)
Entity type:Individual
Prefix:MRS
First Name:YASMEEN
Middle Name:
Last Name:KHAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32350 LA HWY 16, BLDG. C
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-1463
Mailing Address - Country:US
Mailing Address - Phone:225-664-1456
Mailing Address - Fax:866-704-8540
Practice Address - Street 1:32350 LA HWY 16, BLDG. C
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-1463
Practice Address - Country:US
Practice Address - Phone:225-664-1456
Practice Address - Fax:866-704-8540
Is Sole Proprietor?:No
Enumeration Date:2007-09-26
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA01874F225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist