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NPI Code Detail

MEDICARE: FAITH HORRELL

MEDICARE:   FAITH  HORRELL
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1336845833
Entity Type Code : Individual
Provider Name (Legal Business Name) : FAITH HORRELL
Provider Business Mailing Address
First Line : 8508 MEADOW SWEET LN
Second Line :
City : FORT WORTH
State : TX
Zip : 76123-5042
Country : US
Telephone Number : 817-477-7173
Fax Number :
Provider Business Practice Location Address
First Line : 8508 MEADOW SWEET LN
Second Line :
City : FORT WORTH
State : TX
Zip : 76123-5042
Country : US
Telephone Number : 817-477-7173
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2023
Last Update Date : 02/06/2023

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Directions to “ FAITH HORRELL ” Practice Location

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