Provider Demographics
NPI:1457605990
Name:HOUTSCH, DANIELLE S (COTA)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:S
Last Name:HOUTSCH
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4231 N COUNTY ROAD 1050 E
Mailing Address - Street 2:
Mailing Address - City:OTWELL
Mailing Address - State:IN
Mailing Address - Zip Code:47564-8842
Mailing Address - Country:US
Mailing Address - Phone:812-582-2938
Mailing Address - Fax:
Practice Address - Street 1:303 N HURSTBOURNE PKWY STE 200
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-5158
Practice Address - Country:US
Practice Address - Phone:502-412-5847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-06
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN32001959A224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant