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General NPI Number Information
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NPI Number | 1437263514
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Entity Type | Individual
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Provider Name | ANN MICHELE HORSTMAN PH.D.
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Gender | Female
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 06/18/2015
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Provider Practice Location Address
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Address Line | 201 SE 124TH AVE SUITE 202
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City | VANCOUVER
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State | WA
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Zip | 98684-6066
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Country | US
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Telephone | 360-718-1433
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Fax | 360-944-9765
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Provider Business Mailing Address
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Address Line | 201 SE 124TH AVE SUITE 202
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City | VANCOUVER
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State | WA
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Zip | 98684-6066
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Country | US
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Telephone | 360-718-1433
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Fax | 360-944-9765
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY00001325
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0996
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License Number State | OR
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