Provider Demographics
NPI:1225225634
Name:HORN, COLETTE C (PHD)
Entity Type:Individual
Prefix:DR
First Name:COLETTE
Middle Name:C
Last Name:HORN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 W COURTLAND ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-3749
Mailing Address - Country:US
Mailing Address - Phone:410-838-5270
Mailing Address - Fax:
Practice Address - Street 1:25 W COURTLAND ST
Practice Address - Street 2:SUITE 202
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-3749
Practice Address - Country:US
Practice Address - Phone:410-838-5270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-29
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD2823103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD288AOtherBLUE CROSS BLUE SHIELD