Provider Demographics
NPI:1104182351
Name:HORRISLAND, ANTOINETTE MARIE (MSSLP)
Entity Type:Individual
Prefix:MRS
First Name:ANTOINETTE
Middle Name:MARIE
Last Name:HORRISLAND
Suffix:
Gender:F
Credentials:MSSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 N MIDDLETOWN RD
Mailing Address - Street 2:
Mailing Address - City:PEARL RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:10965-2018
Mailing Address - Country:US
Mailing Address - Phone:845-746-1415
Mailing Address - Fax:
Practice Address - Street 1:76 N MIDDLETOWN RD
Practice Address - Street 2:
Practice Address - City:PEARL RIVER
Practice Address - State:NY
Practice Address - Zip Code:10965-2018
Practice Address - Country:US
Practice Address - Phone:845-746-1415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-02
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021793235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist