Stanley Houston, OTA

Individual provider Active NPI Occupational Therapy Assistant · Heathrow, FL

NPI 1548457781 · NPPES record last updated Oct 2, 2007

Key facts

NPI
1548457781
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
OC00001252 (WA)
Practice address
1485 International Pkwy
#2051
Heathrow, FL 32746-5303
Phone
(800) 798-6035
NPI assigned
Oct 2, 2007
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
OC00001252WAMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Voyage Staffing Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OC00001252 WA Yes

Addresses

Primary practice location

1485 International Pkwy
#2051
Heathrow, FL 32746-5303

Mailing address

4913 Plomondon St
Apt.# 22
Vancouver, WA 98661-6163

Other providers in Heathrow, FL

All providers in Heathrow, FL · Occupational Therapy Assistant in Florida

Sources for this page

Verify at the official NPI Registry.