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General NPI Number Information
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NPI Number | 1255747168
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Entity Type | Individual
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Provider Name | CHARLES HORTON SR.
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Gender | Male
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Dates
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Enumeration Date | 07/11/2014
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Last Update Date | 07/11/2014
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Provider Practice Location Address
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Address Line | 301 SPRING GARDEN ROAD
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City | WINSLOW
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State | NJ
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Zip | 08095-0080
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Country | US
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Telephone | 609-561-0269
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Fax | 609-561-7604
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Provider Business Mailing Address
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Address Line | 301 SPRING GARDEN ROAD
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City | WINSLOW
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State | NJ
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Zip | 08095-0080
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Country | US
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Telephone | 609-561-0269
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Fax | 609-561-7604
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 37PC00490800
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License Number State | NJ
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