Healthcare Provider Details

I. General information

NPI: 1508982547
Provider Name (Legal Business Name): CHRIS HOUSKA M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106B DIVISION AVE. N.
CAVALIER ND
58220
US

IV. Provider business mailing address

1423 MANVEL AVE
GRAFTON ND
58237-1869
US

V. Phone/Fax

Practice location:
  • Phone: 701-265-8080
  • Fax:
Mailing address:
  • Phone: 701-352-2186
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number365
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: