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General NPI Number Information
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NPI Number | 1063653616
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Entity Type | Individual
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Provider Name | JEANNETTE MAE HORTON LMHC
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Gender | Female
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Dates
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Enumeration Date | 03/11/2009
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Last Update Date | 12/11/2015
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Provider Practice Location Address
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Address Line | 112 12TH STREET
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City | YELM
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State | WA
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Zip | 98597-9656
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Country | US
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Telephone | 360-778-2249
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 45610
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City | OLYMPIA
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State | WA
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Zip | 98504-5610
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Country | US
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Telephone | 360-778-2449
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LH60401133
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CP60115601
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License Number State | WA
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