Provider Demographics
NPI:1912624123
Name:HOWARD, MARIAH ELISE
Entity Type:Individual
Prefix:
First Name:MARIAH
Middle Name:ELISE
Last Name:HOWARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 S PAXTON ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51106-4826
Mailing Address - Country:US
Mailing Address - Phone:315-512-8809
Mailing Address - Fax:
Practice Address - Street 1:1115 5TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51101-1905
Practice Address - Country:US
Practice Address - Phone:712-225-0890
Practice Address - Fax:712-276-6040
Is Sole Proprietor?:No
Enumeration Date:2022-10-27
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health