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General NPI Number Information
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NPI Number | 1750804852
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Entity Type | Individual
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Provider Name | TAMIKO HORNE LAPC
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Gender | Female
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Dates
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Enumeration Date | 07/20/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2484 INGLESIDE AVE STE 102
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City | MACON
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State | GA
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Zip | 31204-2089
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Country | US
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Telephone | 478-304-4878
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Fax |
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Provider Business Mailing Address
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Address Line | 2484 INGLESIDE AVE BLDG B SUITE 102
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City | MACON
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State | GA
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Zip | 31204
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Country | US
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Telephone | 478-304-4878
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | APC005549
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License Number State | GA
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