Provider Demographics
NPI:1265673859
Name:HORN, TONJA ANNETTE (LPC)
Entity Type:Individual
Prefix:MS
First Name:TONJA
Middle Name:ANNETTE
Last Name:HORN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2727
Mailing Address - Street 2:
Mailing Address - City:FORT RILEY
Mailing Address - State:KS
Mailing Address - Zip Code:66442-0727
Mailing Address - Country:US
Mailing Address - Phone:785-709-9150
Mailing Address - Fax:
Practice Address - Street 1:8909 RIDGE LN
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:KS
Practice Address - Zip Code:66514-9377
Practice Address - Country:US
Practice Address - Phone:785-709-9150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-12
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3943101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional