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General NPI Number Information
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NPI Number | 1801300306
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Entity Type | Individual
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Provider Name | JOHN PHILIP VANHORN JR. PSYD
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Gender | Male
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Dates
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Enumeration Date | 11/21/2017
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Last Update Date | 05/21/2020
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Provider Practice Location Address
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Address Line | 108 LEE ST E RM 129
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City | CHARLESTON
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State | WV
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Zip | 25301-1506
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Country | US
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Telephone | 681-205-2455
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Fax |
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Provider Business Mailing Address
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Address Line | 52 GOODWILL RD
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City | HUNTINGTON
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State | WV
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Zip | 25704-8820
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Country | US
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Telephone | 304-654-3812
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State | WV
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