Provider Demographics
NPI:1316703457
Name:HOUNSOKOU, ANNIE KRISTELLE
Entity type:Individual
Prefix:
First Name:ANNIE
Middle Name:KRISTELLE
Last Name:HOUNSOKOU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1029 N WEBSTER AVE
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18510-1311
Mailing Address - Country:US
Mailing Address - Phone:570-344-2372
Mailing Address - Fax:
Practice Address - Street 1:288 S MAIN AVE
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18504
Practice Address - Country:US
Practice Address - Phone:570-904-7363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health