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NPI Code Detail

MEDICARE: ELIZABETH W. HORTON, MSW, LTD.

MEDICARE: ELIZABETH W. HORTON, MSW, LTD.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)00201MN

General Provider Information

NPI Number : 1043304827
Entity Type Code : Organization
Provider Name (Legal Business Name) : ELIZABETH W. HORTON, MSW, LTD.
Provider Business Mailing Address
First Line : 3131 EXCELSIOR BLVD
Second Line : #306
City : MINNEAPOLIS
State : MN
Zip : 55416-4600
Country : US
Telephone Number : 612-702-8631
Fax Number : 612-920-6957
Provider Business Practice Location Address
First Line : 3131 EXCELSIOR BLVD
Second Line : #306
City : MINNEAPOLIS
State : MN
Zip : 55416-4600
Country : US
Telephone Number : 612-702-8631
Fax Number : 612-920-6957
Authorized Official
Title or Position : PRESIDENT
Name : MRS. ELIZABETH W HORTON
Credential : LICSW
Telephone Number : 612-702-8631
Provider Enumeration Date : 10/03/2006
Last Update Date : 08/22/2020

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