Provider Demographics
NPI:1528678471
Name:HOUSTON, DEIDRE
Entity type:Individual
Prefix:
First Name:DEIDRE
Middle Name:
Last Name:HOUSTON
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 1:1830 MONTCLAIR RD STE A
Mailing Address - Street 2:
Mailing Address - City:IRONDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35210-2645
Mailing Address - Country:US
Mailing Address - Phone:205-775-0300
Mailing Address - Fax:205-618-9706
Practice Address - Street 1:109 FOOTHILLS PKWY STE 113
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:AL
Practice Address - Zip Code:35043-8236
Practice Address - Country:US
Practice Address - Phone:205-618-9899
Practice Address - Fax:205-618-9706
Is Sole Proprietor?:No
Enumeration Date:2020-08-05
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker