Provider Demographics
NPI:1699960575
Name:HOUCK, MISTI MICHELE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MISTI
Middle Name:MICHELE
Last Name:HOUCK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2893 STURGIS RD
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-6607
Mailing Address - Country:US
Mailing Address - Phone:803-366-9090
Mailing Address - Fax:
Practice Address - Street 1:2893 STURGIS RD
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-6607
Practice Address - Country:US
Practice Address - Phone:803-366-9090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-13
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN29398183500000X
AZS016129183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist