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General NPI Number Information
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NPI Number | 1063984805
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Entity Type | Individual
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Provider Name | KYLIE R HORNER
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Gender | Female
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Dates
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Enumeration Date | 12/18/2018
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Last Update Date | 12/18/2018
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Provider Practice Location Address
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Address Line | 330 W 58TH ST STE 409
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City | NEW YORK
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State | NY
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Zip | 10019
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Country | US
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Telephone | 212-877-5500
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Fax |
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Provider Business Mailing Address
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Address Line | 42 DRIGGS AVE APT 3C
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City | BROOKLYN
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State | NY
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Zip | 11222-4524
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Country | US
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Telephone | 856-381-8485
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 103951-1
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License Number State | NY
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