Provider Demographics
NPI:1982422424
Name:HOUSTON, TAYAH LILY
Entity type:Individual
Prefix:
First Name:TAYAH
Middle Name:LILY
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 1:14707 E 2ND AVE # GL100
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-8965
Mailing Address - Country:US
Mailing Address - Phone:214-909-8498
Mailing Address - Fax:
Practice Address - Street 1:14707 E 2ND AVE # GL100
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-8965
Practice Address - Country:US
Practice Address - Phone:214-909-8498
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician