Provider Demographics
NPI:1609997105
Name:HOUSER, KYRA MARTIN (MS, LPC)
Entity Type:Individual
Prefix:MRS
First Name:KYRA
Middle Name:MARTIN
Last Name:HOUSER
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3017 STRATFORD DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-2624
Mailing Address - Country:US
Mailing Address - Phone:336-288-8488
Mailing Address - Fax:
Practice Address - Street 1:3017 STRATFORD DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-2624
Practice Address - Country:US
Practice Address - Phone:336-288-8488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3376101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health