Provider Demographics
NPI:1831978634
Name:HOUSTON, BRITTANY AILEEN
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:AILEEN
Last Name:HOUSTON
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 1:1300 SW PARK AVE APT 512
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97201-3553
Mailing Address - Country:US
Mailing Address - Phone:707-740-5006
Mailing Address - Fax:
Practice Address - Street 1:1300 SW PARK AVE APT 512
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97201-3553
Practice Address - Country:US
Practice Address - Phone:707-740-5006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-22
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician