Provider Demographics
NPI:1720119993
Name:HOUGHLAND, JANICE EUNICE (MS)
Entity Type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:EUNICE
Last Name:HOUGHLAND
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MISS
Other - First Name:JANICE
Other - Middle Name:EUNICE
Other - Last Name:SHEPHERD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1352 W 15TH LN
Mailing Address - Street 2:
Mailing Address - City:APACHE JUNCTION
Mailing Address - State:AZ
Mailing Address - Zip Code:85220-6227
Mailing Address - Country:US
Mailing Address - Phone:480-694-9587
Mailing Address - Fax:623-321-1876
Practice Address - Street 1:1352 W 15TH LN
Practice Address - Street 2:
Practice Address - City:APACHE JUNCTION
Practice Address - State:AZ
Practice Address - Zip Code:85220-6227
Practice Address - Country:US
Practice Address - Phone:480-694-9587
Practice Address - Fax:623-321-1786
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0771174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist