Provider Demographics
NPI:1558699694
Name:HOUCK, ELIZABETH (MED)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:
Last Name:HOUCK
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61571-2646
Mailing Address - Country:US
Mailing Address - Phone:800-773-1682
Mailing Address - Fax:800-773-1682
Practice Address - Street 1:169 VILLAGE ESTATES DR
Practice Address - Street 2:
Practice Address - City:HIGHLAND VILLAGE
Practice Address - State:TX
Practice Address - Zip Code:75077-7118
Practice Address - Country:US
Practice Address - Phone:469-585-8184
Practice Address - Fax:800-773-1682
Is Sole Proprietor?:No
Enumeration Date:2009-12-01
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst