Provider Demographics
NPI:1508982547
Name:HOUSKA, CHRIS (MS)
Entity Type:Individual
Prefix:MRS
First Name:CHRIS
Middle Name:
Last Name:HOUSKA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1423 MANVEL AVE
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:ND
Mailing Address - Zip Code:58237-1869
Mailing Address - Country:US
Mailing Address - Phone:701-352-2186
Mailing Address - Fax:
Practice Address - Street 1:106B DIVISION AVE. N.
Practice Address - Street 2:
Practice Address - City:CAVALIER
Practice Address - State:ND
Practice Address - Zip Code:58220
Practice Address - Country:US
Practice Address - Phone:701-265-8080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND365235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND59449Medicaid
ND365OtherSTATE LICENSE