Khatidja S Ali
Individual provider Active NPI Health Service Psychologist · Memphis, TN
NPI 1700123239 · NPPES record last updated Jan 3, 2013
Key facts
- NPI
- 1700123239
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Health Service Psychologist 103TH0100X
- License
- P0000003082 (TN)
- Practice address
- 1030 Jefferson Ave
Memphis, TN 38104 - Phone
- (901) 523-8990
- NPI assigned
- Jan 3, 2013
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P0000003082 | TN | MD | Health Service Psychologist |
| 3082 | TN | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Service Psychologist | 103TH0100X | P0000003082 | TN | Yes |
Addresses
Primary practice location
1030 Jefferson Ave
Memphis, TN 38104
Mailing address
1030 Jefferson Ave
Memphis, TN 38104
Phone (901) 523-8990
Other providers in Memphis, TN
- Majid Mohamed Alhazmi
- Mohannad Alhusaini
- Famo Ali
- Jeanelle Sonya Ali
- Kashif Ali
- Mona Ali
- Muneeza Ali
- Yasmin Ali
- Katherine Grace Aliotta
- All 4 U, LLC
All providers in Memphis, TN · Health Service Psychologist in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 3, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.