Provider Information for 1437374436
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PHYLLIS HOUSTON LPC
Sex: Female
NPI: 1437374436
Last Updated: 2023-08-17
Certification Date: 2023-08-17
Certification Date: 2023-08-17
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1437374436 | ||||||||
| Enumeration Date | 2007-04-16 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 208 ACADIA LN MADISON, MS 39110-8433 United States Phone: 601-212-2056 | Fax: | ||||||||
| Primary Practice Address | 4500 I 55 N JACKSON, MS 39211-5930 United States Phone: 601-212-2056 | Fax: | ||||||||
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