Provider Demographics
NPI:1437048402
Name:HOUGHTON, JENNIFER
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:HOUGHTON
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 1:13709 YORK BLVD
Mailing Address - Street 2:
Mailing Address - City:GARFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-4058
Mailing Address - Country:US
Mailing Address - Phone:734-331-0222
Mailing Address - Fax:
Practice Address - Street 1:675 COOPER ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48161-1676
Practice Address - Country:US
Practice Address - Phone:734-331-0222
Practice Address - Fax:734-331-0222
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172A00000X, 282J00000X
OH602998900325251E00000X, 251J00000X, 253Z00000X, 376K00000X
OHRP953528332U00000X, 343900000X, 342000000X, 347B00000X, 347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No172A00000XOther Service ProvidersDriver
No251E00000XAgenciesHome Health
No282J00000XHospitalsReligious Nonmedical Health Care Institution
No332U00000XSuppliersHome Delivered Meals
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No342000000XTransportation ServicesTransportation Network Company
No347B00000XTransportation ServicesBus
No347C00000XTransportation ServicesPrivate Vehicle
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty