Healthcare Provider Details

I. General information

NPI: 1932018264
Provider Name (Legal Business Name): ADDISON REESE HORN PCT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10802 N SCOTTSDALE RD
SCOTTSDALE AZ
85254-5242
US

IV. Provider business mailing address

11601 N 74TH PL
SCOTTSDALE AZ
85260-5406
US

V. Phone/Fax

Practice location:
  • Phone: 480-489-6842
  • Fax:
Mailing address:
  • Phone: 480-489-6842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: