MEDICARE: MS. TONJA ANNETTE HORN L.P.C.

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
1	101YP2500X	Professional Counselor	3943	NC

General Provider Information

NPI Number	:	1265673859
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TONJA ANNETTE HORN L.P.C.

Provider Business Mailing Address
First Line	:	PO BOX 2727
Second Line	:
City	:	FORT RILEY
State	:	KS
Zip	:	66442-0727
Country	:	US
Telephone Number	:	785-709-9150
Fax Number	:

Provider Business Practice Location Address
First Line	:	8909 RIDGE LN
Second Line	:
City	:	MILFORD
State	:	KS
Zip	:	66514-9377
Country	:	US
Telephone Number	:	785-709-9150
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/12/2009
Last Update Date	:	06/09/2009

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