Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 2018007521 | MO |
NPI | 1003318213 |
---|---|
Provider Name | Stephanie Leigh Houin |
First Address | Florissant, MO 63033-6831 |
Second Address | Saint Peters, MO 63376-1667 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2018 |
Last Update Date | 04/05/2021 |