Provider Demographics
NPI:1013462621
Name:KHOURY, NATASHA (MA, MED)
Entity Type:Individual
Prefix:MS
First Name:NATASHA
Middle Name:
Last Name:KHOURY
Suffix:
Gender:F
Credentials:MA, MED
Other - Prefix:MS
Other - First Name:NATASHA
Other - Middle Name:
Other - Last Name:KHOURY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, MED
Mailing Address - Street 1:274 MARKET STREET
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-2159
Mailing Address - Country:US
Mailing Address - Phone:610-322-3164
Mailing Address - Fax:
Practice Address - Street 1:274 MARKET STREET
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-2159
Practice Address - Country:US
Practice Address - Phone:610-322-3164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-24
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health