Provider Demographics
NPI:1609415504
Name:STEINHORST, PRISCILLA DANIELLE
Entity Type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:DANIELLE
Last Name:STEINHORST
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 1:3662 CEDARCREST RD STE 220
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-8765
Mailing Address - Country:US
Mailing Address - Phone:470-531-0512
Mailing Address - Fax:
Practice Address - Street 1:3662 CEDARCREST RD STE 220
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-8765
Practice Address - Country:US
Practice Address - Phone:470-531-0512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-26
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician