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NPI Code Detail

MEDICARE: DR. ANNETTE STRICKLAND VAN HORN PSY.D.

MEDICARE: DR. ANNETTE STRICKLAND VAN HORN PSY.D.
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
1103TC0700XClinical PsychologistPY 9218FL

General Provider Information

NPI Number : 1366891277
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANNETTE STRICKLAND VAN HORN PSY.D.
Provider Business Mailing Address
First Line : 460 TOWN PLAZA AVE
Second Line : SUITE 230
City : PONTE VEDRA
State : FL
Zip : 32081-0574
Country : US
Telephone Number : 904-297-5565
Fax Number :
Provider Business Practice Location Address
First Line : 460 TOWN PLAZA AVE
Second Line : SUITE 230
City : PONTE VEDRA
State : FL
Zip : 32081-0574
Country : US
Telephone Number : 904-297-5565
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2016
Last Update Date : 06/10/2016

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