Provider Demographics
NPI:1164999280
Name:HOUST, DEBRA HOFFMANN (PHD)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:HOFFMANN
Last Name:HOUST
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MEDICAL DEPARTMENT
Mailing Address - Street 2:USS CARL VINSON CVN 70
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96629-2840
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:MEDICAL DEPARTMENT
Practice Address - Street 2:USS CARL VINSON CVN 70
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96629-2840
Practice Address - Country:US
Practice Address - Phone:757-953-5814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-26
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHP.07971103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical