Healthcare Provider Details

I. General information

NPI: 1225942402
Provider Name (Legal Business Name): ALLISON EMMA HORN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4950 W PRESCOTT ST UNIT 3204
TAMPA FL
33616-2955
US

IV. Provider business mailing address

4950 W PRESCOTT ST UNIT 3204
TAMPA FL
33616-2955
US

V. Phone/Fax

Practice location:
  • Phone: 630-753-9662
  • Fax:
Mailing address:
  • Phone: 630-753-9662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberISW23211
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: