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General NPI Number Information
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NPI Number | 1518655604
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Entity Type | Individual
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Provider Name | KATHRYN J HOUSH RDH
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Gender | Female
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Dates
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Enumeration Date | 04/26/2023
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Last Update Date | 04/26/2023
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Provider Practice Location Address
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Address Line | 2209 OAK RIDGE DR
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City | NEOSHO
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State | MO
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Zip | 64850-9092
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Country | US
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Telephone | 417-451-0977
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Fax | 417-451-7094
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Provider Business Mailing Address
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Address Line | 901 MACY DR
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City | NEOSHO
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State | MO
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Zip | 64850-3102
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Country | US
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Telephone | 417-214-2158
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 2023014634
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License Number State | MO
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