Provider Demographics
NPI:1336680677
Name:HORTON, LOTTIE (BS)
Entity Type:Individual
Prefix:
First Name:LOTTIE
Middle Name:
Last Name:HORTON
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3131 W CRAIG RD STE 180
Mailing Address - Street 2:
Mailing Address - City:N LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-0861
Mailing Address - Country:US
Mailing Address - Phone:702-469-7897
Mailing Address - Fax:
Practice Address - Street 1:3131 W. CRAIG RD SUITE 180
Practice Address - Street 2:
Practice Address - City:N LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032
Practice Address - Country:US
Practice Address - Phone:702-469-7897
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-20
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health