Provider Demographics
NPI:1710406038
Name:KOURI, DANIELLE (LMFT)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:KOURI
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:PO BOX 250343
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91225-0343
Mailing Address - Country:US
Mailing Address - Phone:323-471-4192
Mailing Address - Fax:
Practice Address - Street 1:10120 RIVERSIDE DR FL 1
Practice Address - Street 2:
Practice Address - City:TOLUCA LAKE
Practice Address - State:CA
Practice Address - Zip Code:91602-2518
Practice Address - Country:US
Practice Address - Phone:323-471-4192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-18
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
CA99406106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist