Provider Demographics
NPI:1619156320
Name:HOUN, ROBERTA LEE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ROBERTA
Middle Name:LEE
Last Name:HOUN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 S 12TH ST
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58504-5622
Mailing Address - Country:US
Mailing Address - Phone:701-223-3175
Mailing Address - Fax:701-222-3186
Practice Address - Street 1:210 S 12TH ST
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58504-5622
Practice Address - Country:US
Practice Address - Phone:701-223-3175
Practice Address - Fax:701-222-3186
Is Sole Proprietor?:No
Enumeration Date:2007-10-30
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND427235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist