Houghton, Koreen
Houghton, Koreen is an individual health care provider with primary practice located at 2108 63Rd St , Kenosha WI 53143-4454. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Houghton, Koreen can be contacted via phone (262) 652-2406.Contact Information
Primary practice address
2108 63Rd St
Kenosha WI 53143-4454
Phone: (262) 652-2406
Fax: (262) 652-2408
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 2376-123 | Wisconsin |
Profile Details
| NPI number | 1659428696 |
|---|---|
| LBN Legal business name | Houghton, Koreen |
| Credentials | MS |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 4th, 2007 |
| Last updated | Jun 30th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659428696 | NPPES |
| Wisconsin | MEDICAID | 43560800 |
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