Healthcare Provider Details

I. General information

NPI: 1922753375
Provider Name (Legal Business Name): PILI HOUSTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2022
Last Update Date: 02/15/2022
Certification Date: 02/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 N POINT BLVD STE 128
BALTIMORE MD
21224-3417
US

IV. Provider business mailing address

1008 FOXRIDGE LN
ESSEX MD
21221-5913
US

V. Phone/Fax

Practice location:
  • Phone: 443-231-3040
  • Fax:
Mailing address:
  • Phone: 410-382-2323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberADT2369
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: