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General NPI Number Information
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NPI Number | 1598324402
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Entity Type | Individual
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Provider Name | DAISIA HORNSBY
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Gender | Female
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Dates
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Enumeration Date | 06/13/2019
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Last Update Date | 01/08/2025
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Provider Practice Location Address
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Address Line | 56100 BITTERSWEET RD
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City | MISHAWAKA
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State | IN
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Zip | 46545-7715
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Country | US
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Telephone | 574-258-9500
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Fax |
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Provider Business Mailing Address
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Address Line | 1435 FLEMING ST
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City | GRANGER
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State | IN
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Zip | 46530-1325
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Country | US
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Telephone | 951-203-6690
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 000010395
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License Number State | IN
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