Provider Demographics
NPI:1831500537
Name:KHOURY, MAUNI (M ED, CAGS)
Entity Type:Individual
Prefix:
First Name:MAUNI
Middle Name:
Last Name:KHOURY
Suffix:
Gender:F
Credentials:M ED, CAGS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21620 MASTICK RD
Mailing Address - Street 2:A
Mailing Address - City:FAIRVIEW PARK
Mailing Address - State:OH
Mailing Address - Zip Code:44126-3047
Mailing Address - Country:US
Mailing Address - Phone:440-356-3525
Mailing Address - Fax:
Practice Address - Street 1:21620 MASTICK RD
Practice Address - Street 2:A
Practice Address - City:FAIRVIEW PARK
Practice Address - State:OH
Practice Address - Zip Code:44126-3047
Practice Address - Country:US
Practice Address - Phone:440-356-3525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-15
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist