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NPI Code Detail

MEDICARE: MRS. TESSIE GRACE HORNING LMLP

MEDICARE: MRS. TESSIE GRACE HORNING LMLP
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
1103T00000XPsychologist851KS

General Provider Information

NPI Number : 1356383970
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TESSIE GRACE HORNING LMLP
Provider Business Mailing Address
First Line : 3751 W MAIN ST
Second Line :
City : INDEPENDENCE
State : KS
Zip : 67301-8446
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3751 W MAIN ST
Second Line :
City : INDEPENDENCE
State : KS
Zip : 67301-8446
Country : US
Telephone Number : 620-331-1748
Fax Number : 620-332-1940
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2006
Last Update Date : 07/08/2007

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Directions to “ MRS. TESSIE GRACE HORNING LMLP” Practice Location

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