MEDICARE: MRS. MADISON HORNE MA

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1366074858
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MADISON HORNE MA

Provider Business Mailing Address
First Line	:	821 WINSLOW DR
Second Line	:
City	:	NEWPORT NEWS
State	:	VA
Zip	:	23608-1176
Country	:	US
Telephone Number	:	276-210-5658
Fax Number	:

Provider Business Practice Location Address
First Line	:	809 MAIN ST STE 101
Second Line	:
City	:	NEWPORT NEWS
State	:	VA
Zip	:	23605-1090
Country	:	US
Telephone Number	:	757-514-1588
Fax Number	:

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

Provider Enumeration Date	:	02/12/2020
Last Update Date	:	11/27/2023

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