Provider Demographics
NPI:1003570425
Name:HORN, KELSIE PAIGE
Entity Type:Individual
Prefix:
First Name:KELSIE
Middle Name:PAIGE
Last Name:HORN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14115 TORREY VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77014-1829
Mailing Address - Country:US
Mailing Address - Phone:281-793-8165
Mailing Address - Fax:
Practice Address - Street 1:16717 ELLA BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-4213
Practice Address - Country:US
Practice Address - Phone:281-793-8165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-22
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118532235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty