Individual
DR. HOLLY OUIDA HOUSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
18161 MORRIS AVE, SUITE 102, HOMEWOOD, IL 60430-2108
(708) 349-5433
(708) 349-5433
Mailing address
2615 BRASSIE AVE, FLOSSMOOR, IL 60422-1819
(708) 957-7718
(708) 957-7721
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071004128
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CH6894
PTAN MEDICARE RAILROAD
IL
Enumeration date
11/09/2007
Last updated
06/12/2016
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