Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | 0701002272 | VA |
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 0718000177 | VA |
NPI | 1013022383 |
---|---|
Provider Name | Lois B. Horne |
First Address | Staunton, VA 24401-3113 |
Second Address | Staunton, VA 24401-3113 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5404606 | (05) | VA |