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General NPI Number Information
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NPI Number | 1497603864
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Entity Type | Individual
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Provider Name | AVERY HOUSTON
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Gender | Female
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Dates
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Enumeration Date | 03/20/2026
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Last Update Date | 03/20/2026
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Provider Practice Location Address
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Address Line | 373 BLAIR PARK RD
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City | WILLISTON
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State | VT
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Zip | 05495-8037
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Country | US
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Telephone | 802-876-7187
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Fax |
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Provider Business Mailing Address
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Address Line | 200 ELM ST
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City | MONTPELIER
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State | VT
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Zip | 05602-2205
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Country | US
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Telephone | 802-223-0954
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Fax |
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 164.0001833
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License Number State | VT
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