Provider Demographics
NPI:1740528405
Name:KURIYAMA, PATRICIA (MAC, LPC, CMHC)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:
Last Name:KURIYAMA
Suffix:
Gender:F
Credentials:MAC, LPC, CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3231 S 2410 W
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:UT
Mailing Address - Zip Code:84075-1145
Mailing Address - Country:US
Mailing Address - Phone:806-292-7841
Mailing Address - Fax:
Practice Address - Street 1:375 N MAIN ST
Practice Address - Street 2:
Practice Address - City:KAYSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84037-1199
Practice Address - Country:US
Practice Address - Phone:801-989-3488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-30
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13295695-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health