Provider Demographics
NPI:1659924371
Name:HORN, PAIGE T (MS CF-SLP)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:T
Last Name:HORN
Suffix:
Gender:F
Credentials:MS CF-SLP
Other - Prefix:
Other - First Name:PAIGE
Other - Middle Name:TAYLOR
Other - Last Name:APPEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:625 E HATTIE AVE
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-3561
Mailing Address - Country:US
Mailing Address - Phone:715-475-8479
Mailing Address - Fax:
Practice Address - Street 1:6270 N GOVERNMENT WAY
Practice Address - Street 2:
Practice Address - City:DALTON GARDENS
Practice Address - State:ID
Practice Address - Zip Code:83815-9214
Practice Address - Country:US
Practice Address - Phone:208-666-0611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-22
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDTSLP-3957235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist