Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 2439 057 | WI |
NPI | 1154307148 |
---|---|
Provider Name | Dr. Patricia A Horn |
First Address | Sheboygan, WI 53081-4405 |
Second Address | Sheboygan, WI 53081-4405 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
39144600 | (05) | WI |