Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PSY1000061 | DC |
Y | 103T00000X | Psychologist | PSY1000061 | DC |
NPI | 1013916535 |
---|---|
Provider Name | Neal Horen |
First Address | Boston, MA 02241-8407 |
Second Address | Washington, DC 20007-2113 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2005 |
Last Update Date | 11/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C25807 | (02) |