Healthcare Provider Details

I. General information

NPI: 1629675087
Provider Name (Legal Business Name): KARI HOUGH DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2020
Last Update Date: 10/07/2020
Certification Date: 10/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5130 DORSEY HALL DR FL 1
ELLICOTT CITY MD
21042-7870
US

IV. Provider business mailing address

5130 DORSEY HALL DR FL 1
ELLICOTT CITY MD
21042-7870
US

V. Phone/Fax

Practice location:
  • Phone: 443-864-4980
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: