Provider Demographics
NPI:1396866356
Name:KHOURY, FATEN HOPE (MS, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:FATEN
Middle Name:HOPE
Last Name:KHOURY
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1499 BROOKS AVE E
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55109-2012
Mailing Address - Country:US
Mailing Address - Phone:651-206-8646
Mailing Address - Fax:651-206-8646
Practice Address - Street 1:1499 BROOKS AVE E
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-2012
Practice Address - Country:US
Practice Address - Phone:651-206-8646
Practice Address - Fax:651-206-8646
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1371106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist