MEDICARE: WILNISE HORSEY PH.D

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101Y00000X	Counselor
2	101YM0800X	Mental Health Counselor
3	101YP2500X	Professional Counselor
4	103K00000X	Behavior Analyst
5	103T00000X	Psychologist

General Provider Information

NPI Number	:	1457692246
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILNISE HORSEY PH.D

Provider Business Mailing Address
First Line	:	20304 ASH GROVE LN
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-3468
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	20304 ASH GROVE LN
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-3468
Country	:	US
Telephone Number	:	321-747-4362
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/05/2013
Last Update Date	:	03/05/2013

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