Provider Demographics
NPI:1235253329
Name:HORN, JENNIFER L (PHD, HSPP)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:L
Last Name:HORN
Suffix:
Gender:F
Credentials:PHD, HSPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11495 N PENNSYLVANIA ST STE 105
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-6935
Mailing Address - Country:US
Mailing Address - Phone:317-942-4020
Mailing Address - Fax:317-942-4019
Practice Address - Street 1:11495 N PENNSYLVANIA ST STE 105
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-6935
Practice Address - Country:US
Practice Address - Phone:317-942-4020
Practice Address - Fax:317-942-4019
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20040369A103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical