MEDICARE: MS. DENITRESS HOUSTON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1699460584
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DENITRESS HOUSTON

Provider Business Mailing Address
First Line	:	2401 FAIRHILL DR
Second Line	:
City	:	SUITLAND
State	:	MD
Zip	:	20746-2303
Country	:	US
Telephone Number	:	301-357-6556
Fax Number	:

Provider Business Practice Location Address
First Line	:	508 KENNEDY ST NW # 200
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20011-3137
Country	:	US
Telephone Number	:	202-223-9630
Fax Number	:	202-223-9631

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2023
Last Update Date	:	04/07/2023

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