Provider Demographics
NPI:1538307046
Name:HOUGHLAND, AMEE LYNNE
Entity Type:Individual
Prefix:MRS
First Name:AMEE
Middle Name:LYNNE
Last Name:HOUGHLAND
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 1:1515 ANDERSON ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-1724
Mailing Address - Country:US
Mailing Address - Phone:704-770-6102
Mailing Address - Fax:980-225-7013
Practice Address - Street 1:1515 ANDERSON ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28205-1724
Practice Address - Country:US
Practice Address - Phone:704-770-6102
Practice Address - Fax:980-225-7013
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-22
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor