Provider Demographics
NPI:1699460584
Name:HOUSTON, DENITRESS
Entity type:Individual
Prefix:MS
First Name:DENITRESS
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 1:2401 FAIRHILL DR
Mailing Address - Street 2:
Mailing Address - City:SUITLAND
Mailing Address - State:MD
Mailing Address - Zip Code:20746-2303
Mailing Address - Country:US
Mailing Address - Phone:301-357-6556
Mailing Address - Fax:
Practice Address - Street 1:508 KENNEDY ST NW # 200
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-3137
Practice Address - Country:US
Practice Address - Phone:202-223-9630
Practice Address - Fax:202-223-9631
Is Sole Proprietor?:No
Enumeration Date:2023-04-07
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator