Provider Demographics
NPI:1932385697
Name:HOUSE, JOANNA DANIELLE (PTA, COTA)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:DANIELLE
Last Name:HOUSE
Suffix:
Gender:F
Credentials:PTA, COTA
Other - Prefix:
Other - First Name:JOANNA
Other - Middle Name:DANIELLE
Other - Last Name:RUMFELT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA, COTA
Mailing Address - Street 1:18228 BAL HARBOUR DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-4311
Mailing Address - Country:US
Mailing Address - Phone:817-371-7885
Mailing Address - Fax:
Practice Address - Street 1:3000 BELLAIRE RANCH DR
Practice Address - Street 2:APT 1821
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76109-1848
Practice Address - Country:US
Practice Address - Phone:817-205-9594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-12
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2055233225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant