Provider Demographics
NPI:1689019408
Name:HORTON, MARILYN L (BS, CADC)
Entity Type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:L
Last Name:HORTON
Suffix:
Gender:F
Credentials:BS, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1240 BUCKINGHAM CT
Mailing Address - Street 2:
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221-9368
Mailing Address - Country:US
Mailing Address - Phone:517-403-8484
Mailing Address - Fax:
Practice Address - Street 1:1240 BUCKINGHAM CT
Practice Address - Street 2:
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221-9368
Practice Address - Country:US
Practice Address - Phone:517-403-8484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-07
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)