Provider Demographics
NPI:1598381014
Name:HOUSTON, AUBREY LEIGH (SLP)
Entity Type:Individual
Prefix:MRS
First Name:AUBREY
Middle Name:LEIGH
Last Name:HOUSTON
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:MISS
Other - First Name:AUBREY
Other - Middle Name:LEIGH
Other - Last Name:PHILYAW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:344 LAKE RD
Mailing Address - Street 2:
Mailing Address - City:HERTFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27944-8775
Mailing Address - Country:US
Mailing Address - Phone:757-679-1111
Mailing Address - Fax:252-426-9909
Practice Address - Street 1:344 LAKE RD
Practice Address - Street 2:
Practice Address - City:HERTFORD
Practice Address - State:NC
Practice Address - Zip Code:27944-8775
Practice Address - Country:US
Practice Address - Phone:757-659-1111
Practice Address - Fax:252-426-9909
Is Sole Proprietor?:No
Enumeration Date:2020-06-20
Last Update Date:2020-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13868235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist