Healthcare Provider Details

I. General information

NPI: 1437543535
Provider Name (Legal Business Name): KATHY HOUP MFTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2015
Last Update Date: 04/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1351 NEWTOWN PIKE
LEXINGTON KY
40511-1275
US

IV. Provider business mailing address

1351 NEWTOWN PIKE
LEXINGTON KY
40511-1275
US

V. Phone/Fax

Practice location:
  • Phone: 859-233-0444
  • Fax: 859-268-8888
Mailing address:
  • Phone: 859-233-0444
  • Fax: 859-268-8888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFTMFA00216550
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: