Healthcare Provider Details

I. General information

NPI: 1710806922
Provider Name (Legal Business Name): VENUS VAN HORN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8221 E 134TH ST
GRANDVIEW MO
64030-3517
US

IV. Provider business mailing address

8221 E 134TH ST
GRANDVIEW MO
64030-3517
US

V. Phone/Fax

Practice location:
  • Phone: 816-914-0781
  • Fax:
Mailing address:
  • Phone: 816-914-0781
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-2826805
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: