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General NPI Number Information
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NPI Number | 1568513034
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Entity Type | Organization
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Legal Business Name | ANXIETY AND STRESS CENTER, P.C.
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Dates
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Enumeration Date | 01/13/2007
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Last Update Date | 06/12/2016
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Provider Practice Location Address
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Address Line | 18161 MORRIS AVE SUITE 102
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City | HOMEWOOD
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State | IL
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Zip | 60430-2108
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Country | US
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Telephone | 708-349-5433
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Fax | 708-349-5434
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Provider Business Mailing Address
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Address Line | 18161 MORRIS AVE SUITE 102
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City | HOMEWOOD
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State | IL
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Zip | 60430-2108
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Country | US
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Telephone | 708-349-5433
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Fax | 708-349-5434
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Authorized Official
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Title or Position | OWNER
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Name | DR. HOLLY OUIDA HOUSTON
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Credential | PH.D.
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Telephone | 708-349-5433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071004128
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | 071004128
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License Number State | IL
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