MEDICARE: MS. SHEREEN E HORTON MSW

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	1041C0700X	Clinical Social Worker	CW016749	PA

General Provider Information

NPI Number	:	1760717136
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHEREEN E HORTON MSW

Provider Business Mailing Address
First Line	:	201 CHESTNUT AVE
Second Line	:	PO BOX 352
City	:	ALTOONA
State	:	PA
Zip	:	16601-4927
Country	:	US
Telephone Number	:	814-946-5411
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 LAKEMONT PARK BLVD
Second Line	:	SUITE 100
City	:	ALTOONA
State	:	PA
Zip	:	16602-5967
Country	:	US
Telephone Number	:	814-946-0261
Fax Number	:

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

Provider Enumeration Date	:	10/02/2009
Last Update Date	:	08/30/2011

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