Provider Demographics
NPI:1639878705
Name:HORTON, CHARNAE
Entity Type:Individual
Prefix:
First Name:CHARNAE
Middle Name:
Last Name:HORTON
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:DEPARTMENT OF SOCIAL WORK -BHWTP2 GRADUATE SOCIAL WORK
Mailing Address - Street 2:104 BUCHANAN HALL
Mailing Address - City:NORMAL
Mailing Address - State:AL
Mailing Address - Zip Code:35762
Mailing Address - Country:US
Mailing Address - Phone:786-559-5479
Mailing Address - Fax:
Practice Address - Street 1:1037 SANDY SPRINGS RD NW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35806-2411
Practice Address - Country:US
Practice Address - Phone:786-559-5479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-28
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker