Provider Demographics
NPI:1215592290
Name:HOUCHIN, SUMMER RENEE'
Entity Type:Individual
Prefix:
First Name:SUMMER
Middle Name:RENEE'
Last Name:HOUCHIN
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 1:1324 LAWNVILLE RD
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:TN
Mailing Address - Zip Code:37763-4728
Mailing Address - Country:US
Mailing Address - Phone:865-376-3416
Mailing Address - Fax:865-376-3532
Practice Address - Street 1:629 GALLAHER RD
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:TN
Practice Address - Zip Code:37763-4215
Practice Address - Country:US
Practice Address - Phone:865-376-3416
Practice Address - Fax:865-376-3532
Is Sole Proprietor?:No
Enumeration Date:2019-05-06
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5851225XP0019X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation