Provider Demographics
NPI:1427399005
Name:HUSTON, MARY (CLD)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:HUSTON
Suffix:
Gender:F
Credentials:CLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2848 S WHEELING WAY
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-3482
Mailing Address - Country:US
Mailing Address - Phone:720-224-6443
Mailing Address - Fax:
Practice Address - Street 1:2848 S WHEELING WAY
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-3482
Practice Address - Country:US
Practice Address - Phone:720-224-6443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-07
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula