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General NPI Number Information
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NPI Number | 1689119042
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF HOUSTON
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Dates
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Enumeration Date | 12/21/2016
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Last Update Date | 12/21/2016
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Provider Practice Location Address
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Address Line | 4455 CULLEN BLVD
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City | HOUSTON
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State | TX
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Zip | 77204-6018
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Country | US
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Telephone | 713-743-6777
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Fax |
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Provider Business Mailing Address
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Address Line | 4455 CULLEN BLVD
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City | HOUSTON
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State | TX
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Zip | 77204-6018
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Country | US
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Telephone | 713-743-6777
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Fax |
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Authorized Official
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Title or Position | ASSOCIATE PROFESSOR
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Name | DR. KIA NOELLE JOHNSON
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Credential | PH.D., CCC-SLP
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Telephone | 713-743-6777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 112061
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License Number State | TX
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