Provider Demographics
NPI:1205143328
Name:HOUSER, ANGELITA Y (LMT)
Entity type:Individual
Prefix:MRS
First Name:ANGELITA
Middle Name:Y
Last Name:HOUSER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7870 OLENTANGY RIVER RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-1319
Mailing Address - Country:US
Mailing Address - Phone:614-448-4791
Mailing Address - Fax:614-448-4791
Practice Address - Street 1:7870 OLENTANGY RIVER RD
Practice Address - Street 2:SUITE 105
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-1319
Practice Address - Country:US
Practice Address - Phone:614-448-4791
Practice Address - Fax:614-448-4791
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-10
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33018420174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist