Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 2012040982 | MO |
NPI | 1538305453 |
---|---|
Provider Name | Dr. Cynthia Ann Houchins |
First Address | Belton, MO 64012-2400 |
Second Address | Belton, MO 64012-2400 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/12/2008 |
Last Update Date | 31/03/2016 |