Provider Demographics
NPI:1144492174
Name:HOUGHTALEN, GINGER K
Entity type:Individual
Prefix:
First Name:GINGER
Middle Name:K
Last Name:HOUGHTALEN
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 1:1225 E WEISGARBER RD
Mailing Address - Street 2:SUITE 180 SOUTH
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-2604
Mailing Address - Country:US
Mailing Address - Phone:865-584-5558
Mailing Address - Fax:865-584-6607
Practice Address - Street 1:1225 E WEISGARBER RD
Practice Address - Street 2:SUITE 180 SOUTH
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-2604
Practice Address - Country:US
Practice Address - Phone:865-584-5558
Practice Address - Fax:865-584-6607
Is Sole Proprietor?:No
Enumeration Date:2008-03-31
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst