Doctor Name: | JACKIE HOUTZ |
NPI Number: | 1538467899 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | OTR/L |
License Number: | 3130 |
Business Practice Address: | 3756 Grace Falls Dr Antioch, TN - 370131576 |
Business Phone Number: | 6154264235 |
Business Fax Number: | |
Mailing Address: | 3756 Grace Falls Dr, ANTIOCH |
State: | TN |
Postal Code: | 370131576 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 03/09/2011 |
NPI Last Update Date: | 03/09/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 3130 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CO |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |