Healthcare Provider Details

I. General information

NPI: 1982133898
Provider Name (Legal Business Name): MISS ASHLEY HOUCHIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HEALTHCARE DR
PHILIPPI WV
26416-9405
US

IV. Provider business mailing address

1 HEALTHCARE DR
PHILIPPI WV
26416-9405
US

V. Phone/Fax

Practice location:
  • Phone: 304-457-1760
  • Fax: 304-457-1516
Mailing address:
  • Phone: 304-457-1760
  • Fax: 304-457-1516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number0706
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: