Healthcare Provider Details

I. General information

NPI: 1992154801
Provider Name (Legal Business Name): ALLISON HOULE PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2016
Last Update Date: 09/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 N JAMES RD
COLUMBUS OH
43219-1834
US

IV. Provider business mailing address

8293 MIRA ST
COLUMBUS OH
43240-6077
US

V. Phone/Fax

Practice location:
  • Phone: 614-257-5200
  • Fax:
Mailing address:
  • Phone: 828-399-1817
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number05257
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: