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General NPI Number Information
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NPI Number | 1740528405
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Entity Type | Individual
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Provider Name | PATRICIA KURIYAMA MAC, LPC, CMHC
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Gender | Female
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Dates
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Enumeration Date | 01/30/2013
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Last Update Date | 11/11/2024
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Provider Practice Location Address
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Address Line | 375 N MAIN ST
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City | KAYSVILLE
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State | UT
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Zip | 84037-1199
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Country | US
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Telephone | 801-989-3488
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Fax |
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Provider Business Mailing Address
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Address Line | 3231 S 2410 W
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City | SYRACUSE
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State | UT
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Zip | 84075-1145
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Country | US
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Telephone | 806-292-7841
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 13295695-6004
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License Number State | UT
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