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General NPI Number Information
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NPI Number | 1104096916
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Entity Type | Individual
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Provider Name | BARBARA ROSE HORNER O.T.
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Gender | Female
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Dates
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Enumeration Date | 03/07/2008
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Last Update Date | 03/07/2008
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Provider Practice Location Address
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Address Line | 765 WINTERSUN PL
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City | HOLLAND
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State | MI
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Zip | 49424-2788
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Country | US
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Telephone | 616-355-6612
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Fax | 616-355-6617
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Provider Business Mailing Address
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Address Line | 765 WINTERSUN PL
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City | HOLLAND
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State | MI
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Zip | 49424-2788
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Country | US
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Telephone | 616-355-6612
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Fax | 616-355-6617
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 31000779A
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License Number State | IN
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