Provider Demographics
NPI:1588794382
Name:HUSTON, ROBERT E (PHD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:E
Last Name:HUSTON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 16221
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37416-0221
Mailing Address - Country:US
Mailing Address - Phone:423-313-2240
Mailing Address - Fax:
Practice Address - Street 1:717 E 11TH ST
Practice Address - Street 2:HOMELESS HEALTH CARE CENTER
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-3104
Practice Address - Country:US
Practice Address - Phone:423-265-5708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2902103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling