Healthcare Provider Details

I. General information

NPI: 1548193071
Provider Name (Legal Business Name): LIVIA VANHORNE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8401 XERXES AVE S
BLOOMINGTON MN
55431-1631
US

IV. Provider business mailing address

13980 GRANADA CT
APPLE VALLEY MN
55124-7343
US

V. Phone/Fax

Practice location:
  • Phone: 952-806-8939
  • Fax:
Mailing address:
  • Phone: 612-804-2241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number424125
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: