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NPI Code Detail

MEDICARE: MRS. SANDRA S HORNE LICSW

MEDICARE:  MRS. SANDRA S HORNE  LICSW
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
11041C0700XClinical Social Worker101604MA

General Provider Information

NPI Number : 1659461473
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SANDRA S HORNE LICSW
Provider Business Mailing Address
First Line : 15 PHEASANT ROAD
Second Line :
City : NEWTONVILLE
State : MA
Zip : 02460-2419
Country : US
Telephone Number : 617-965-0649
Fax Number : 617-965-0649
Provider Business Practice Location Address
First Line : 93 UNION STREET
Second Line : SUITE 400
City : NEWTON CENTRE
State : MA
Zip : 02459-2241
Country : US
Telephone Number : 617-965-0649
Fax Number : 617-965-0649
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2006
Last Update Date : 07/08/2007

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Directions to “ MRS. SANDRA S HORNE LICSW” Practice Location

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