Provider Demographics
NPI:1215205547
Name:HORTON, WILLIAM D (PSY D)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:D
Last Name:HORTON
Suffix:
Gender:M
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1532 US HIGHWAY 41 BYP S
Mailing Address - Street 2:STE 287
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34293-1032
Mailing Address - Country:US
Mailing Address - Phone:941-408-8551
Mailing Address - Fax:941-408-8552
Practice Address - Street 1:1532 US HIGHWAY 41 BYP S
Practice Address - Street 2:STE 287
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34293-1032
Practice Address - Country:US
Practice Address - Phone:941-408-8551
Practice Address - Fax:941-408-8552
Is Sole Proprietor?:No
Enumeration Date:2011-12-01
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLLPY11103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist