Provider Demographics
NPI:1275768582
Name:HORNER-KING, MOLLIE J (MS, BCBA)
Entity Type:Individual
Prefix:MS
First Name:MOLLIE
Middle Name:J
Last Name:HORNER-KING
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 N POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:IL
Mailing Address - Zip Code:62901-1459
Mailing Address - Country:US
Mailing Address - Phone:618-201-8473
Mailing Address - Fax:
Practice Address - Street 1:406 N POPLAR ST
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:IL
Practice Address - Zip Code:62901-1459
Practice Address - Country:US
Practice Address - Phone:618-201-8473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-16
Last Update Date:2009-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst