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NPI Code Detail

MEDICARE: KRISTI LYNN VANHORN MA, BCBA, LBA

MEDICARE: KRISTI LYNN VANHORN MA, BCBA, LBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1174976658
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTI LYNN VANHORN MA, BCBA, LBA
Provider Business Mailing Address
First Line : PO BOX 931142
Second Line :
City : ATLANTA
State : GA
Zip : 31193-1142
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1400 BROWNING RD # SET195
Second Line :
City : COLUMBIA
State : SC
Zip : 29210-6941
Country : US
Telephone Number : 803-999-3752
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2016
Last Update Date : 04/08/2024

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