Healthcare Provider Details

I. General information

NPI: 1164092953
Provider Name (Legal Business Name): ANNA JOEL HOUGH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2021
Last Update Date: 04/06/2023
Certification Date: 02/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7519 E KIOWA AVE
MESA AZ
85209-6242
US

IV. Provider business mailing address

7519 E KIOWA AVE
MESA AZ
85209-6242
US

V. Phone/Fax

Practice location:
  • Phone: 480-313-0311
  • Fax:
Mailing address:
  • Phone: 480-313-0311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: