Provider Demographics
NPI:1497900534
Name:HORTON, ANN L (RC)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:L
Last Name:HORTON
Suffix:
Gender:F
Credentials:RC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10642 NE 145TH PL
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-4823
Mailing Address - Country:US
Mailing Address - Phone:206-778-7902
Mailing Address - Fax:425-488-6838
Practice Address - Street 1:15600 REDMOND WAY
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3862
Practice Address - Country:US
Practice Address - Phone:206-778-7902
Practice Address - Fax:425-488-6838
Is Sole Proprietor?:No
Enumeration Date:2008-11-17
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH 60159912101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health