Provider Demographics
NPI:1174297931
Name:HOUCHINS, LAURA BETH
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:BETH
Last Name:HOUCHINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4533 BARGER SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:WAYSIDE
Mailing Address - State:WV
Mailing Address - Zip Code:24985-7206
Mailing Address - Country:US
Mailing Address - Phone:304-466-2037
Mailing Address - Fax:
Practice Address - Street 1:4533 BARGER SPRINGS RD
Practice Address - Street 2:
Practice Address - City:WAYSIDE
Practice Address - State:WV
Practice Address - Zip Code:24985-7206
Practice Address - Country:US
Practice Address - Phone:304-466-2037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-05
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant