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Provider Information for 1659535631


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TAMMY HORN LMHC


Sex: Female

NPI: 1659535631
Last Updated: 2012-04-19
Certification Date:

Details

NameValue
NPI1659535631
Enumeration Date2008-07-18
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 1041 GROVE PARK LN
ORANGE PARK, FL 32073-3612
United States

Phone: | Fax:
 
Primary Practice Address 1041 GROVE PARK LN
ORANGE PARK, FL 32073-3612
United States

Phone: 904-226-9716 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101YM0800X - Counselor - Mental HealthFLMH5884