Individual
MRS. DONNELL MARIA HOUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC SLP
Contact information
Practice address
1327 KALAKAKET STREET, FAIRBANKS, AK 99709
(907) 452-4517
(907) 452-4263
Mailing address
PO BOX 268, ESTER, AK 99725
(907) 474-4667
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
75
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
75
STATE LICENSE
AK
01
—
A005
TRICARE
—
05
—
SP2513
—
AK
Enumeration date
03/03/2006
Last updated
07/08/2007
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