MEDICARE: ISAAC HORN LCGC

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
1	170300000X	Genetic Counselor (M.S.)	0139000741	VA

General Provider Information

NPI Number	:	1851124648
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ISAAC HORN LCGC

Provider Business Mailing Address
First Line	:	7607 FOREST AVE STE S00
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23229-4913
Country	:	US
Telephone Number	:	804-545-7991
Fax Number	:

Provider Business Practice Location Address
First Line	:	7607 FOREST AVE STE 200
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23229-4913
Country	:	US
Telephone Number	:	804-545-7991
Fax Number	:

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

Provider Enumeration Date	:	08/26/2024
Last Update Date	:	08/26/2024

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