Provider Demographics
NPI:1346783891
Name:HORNE, MICHAL
Entity Type:Individual
Prefix:
First Name:MICHAL
Middle Name:
Last Name:HORNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 W 236TH ST
Mailing Address - Street 2:APT 4C
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-1748
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:530 W 236TH ST
Practice Address - Street 2:APT 4C
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-1748
Practice Address - Country:US
Practice Address - Phone:201-446-8919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-30
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022560-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist