Healthcare Provider Details

I. General information

NPI: 1578400271
Provider Name (Legal Business Name): DR. STEPHANIE HORTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7444 HUMBOLDT AVE N
BROOKLYN PARK MN
55444-2633
US

IV. Provider business mailing address

4265 KINGSVIEW LN N
PLYMOUTH MN
55446-2731
US

V. Phone/Fax

Practice location:
  • Phone: 763-221-2378
  • Fax:
Mailing address:
  • Phone: 763-913-4150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: