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General NPI Number Information
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NPI Number | 1407044100
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Entity Type | Individual
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Provider Name | JOAN B. HUSTON PH.D.
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Gender | Female
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Dates
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Enumeration Date | 10/09/2007
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Last Update Date | 10/09/2007
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Provider Practice Location Address
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Address Line | 500 PINE STREET
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City | JAMESTOWN
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State | NY
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Zip | 14701
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Country | US
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Telephone | 716-487-9092
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Fax | 215-318-4932
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Provider Business Mailing Address
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Address Line | 426 PARK STREET
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City | JAMESTOWN
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State | NY
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Zip | 14701
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Country | US
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Telephone | 716-487-9092
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Fax | 215-318-4932
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 003937
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License Number State | NY
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