Provider Demographics
NPI:1609963511
Name:HOUZE, DAPHNE MAUREEN (PT)
Entity Type:Individual
Prefix:MRS
First Name:DAPHNE
Middle Name:MAUREEN
Last Name:HOUZE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22874 LINCOLN CT
Mailing Address - Street 2:62 DOUGHTY RD. SUITE,3
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47025-9655
Mailing Address - Country:US
Mailing Address - Phone:812-537-4540
Mailing Address - Fax:812-537-4546
Practice Address - Street 1:62 DOUGHTY RD
Practice Address - Street 2:SUITE 3
Practice Address - City:LAWRENCEBURG
Practice Address - State:IN
Practice Address - Zip Code:47025-2950
Practice Address - Country:US
Practice Address - Phone:812-537-4540
Practice Address - Fax:812-537-4546
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05003796A225100000X
OHPT003885225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN172870Medicare ID - Type Unspecified