Provider Demographics
NPI:1811475742
Name:HARTOUNIAN, MICHELLE TEHRANI (PPS)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:TEHRANI
Last Name:HARTOUNIAN
Suffix:
Gender:F
Credentials:PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 OAK ST APT 317
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-1268
Mailing Address - Country:US
Mailing Address - Phone:818-333-6653
Mailing Address - Fax:
Practice Address - Street 1:223 N JACKSON ST
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-4334
Practice Address - Country:US
Practice Address - Phone:818-241-3111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-02
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA180103464101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool