Provider Demographics
NPI:1174768352
Name:KHATTAR, ARCHNA (LMFT)
Entity type:Individual
Prefix:MS
First Name:ARCHNA
Middle Name:
Last Name:KHATTAR
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 LYNWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WILLIMANTIC
Mailing Address - State:CT
Mailing Address - Zip Code:06226-1330
Mailing Address - Country:US
Mailing Address - Phone:860-655-2048
Mailing Address - Fax:
Practice Address - Street 1:70 LYNWOOD DR
Practice Address - Street 2:
Practice Address - City:WILLIMANTIC
Practice Address - State:CT
Practice Address - Zip Code:06226-1330
Practice Address - Country:US
Practice Address - Phone:860-655-2048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-02
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001069106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist