Provider Demographics
NPI:1245746346
Name:HORNE, SUSAN J'AIMES (BC-HIS)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:J'AIMES
Last Name:HORNE
Suffix:
Gender:F
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6250 LANTANA RD STE 22
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33463-6611
Mailing Address - Country:US
Mailing Address - Phone:561-966-6299
Mailing Address - Fax:
Practice Address - Street 1:6250 LANTANA RD STE 22
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33463-6611
Practice Address - Country:US
Practice Address - Phone:561-966-6299
Practice Address - Fax:561-376-3324
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-27
Last Update Date:2017-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS4784237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist