Individual
MICHAEL HOUSEHOLDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCDC
Contact information
Practice address
2010 AL LIPSCOMB WAY, DALLAS, TX 75215-2773
(469) 516-4472
Mailing address
2010 AL LIPSCOMB WAY, DALLAS, TX 75215-2773
(469) 516-4472
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
12987
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
399885801
—
TX
Enumeration date
09/09/2019
Last updated
09/09/2019
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