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General NPI Number Information
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NPI Number | 1932484862
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Entity Type | Organization
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Legal Business Name | LORRI LIVERS HOUCK, PLLC
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Dates
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Enumeration Date | 10/11/2011
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Last Update Date | 10/11/2011
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Provider Practice Location Address
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Address Line | 105 CRESCENT AVE
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City | LOUISVILLE
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State | KY
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Zip | 40206-1525
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Country | US
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Telephone | 502-897-1999
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Fax | 502-896-1004
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Provider Business Mailing Address
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Address Line | 105 CRESCENT AVE
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City | LOUISVILLE
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State | KY
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Zip | 40206-1525
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Country | US
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Telephone | 502-897-1999
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Fax | 502-896-1004
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | MS. LORRI LIVERS HOUCK
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Credential | APRN, PMHNP-BC
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Telephone | 502-275-9898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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