Individual
ELISA HOUSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16326 POTTER ST, BENNINGTON, NE 68007-1666
(360) 450-1763
Mailing address
16326 POTTER ST, BENNINGTON, NE 68007-1666
(360) 450-1763
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
—
Other
Enumeration date
02/06/2025
Last updated
02/06/2025
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