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Individual

DEIDRE HOUGHTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
534 OWL CREEK DRIVE, POWDER SPRINGS, GA 30127-6285
(770) 361-4124
(678) 290-5587
Mailing address
534 OWL CREEK DRIVE, POWDER SPRINGS, GA 30127-6285
(770) 361-4124
(678) 290-5587

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
005938
GA
225XP0200X
Pediatric Occupational Therapist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
271565429
OCCUPATIONAL THERAPY
05
271565429
GA
Enumeration date
09/11/2017
Last updated
07/21/2022
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