Provider Demographics
NPI:1790409480
Name:SIMPSON-HORNE, ADDIE MARIA
Entity Type:Individual
Prefix:
First Name:ADDIE
Middle Name:MARIA
Last Name:SIMPSON-HORNE
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 1:3005 BLADENSBURG RD NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20018-2265
Mailing Address - Country:US
Mailing Address - Phone:202-808-8583
Mailing Address - Fax:
Practice Address - Street 1:3005 BLADENSBURG RD NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-2265
Practice Address - Country:US
Practice Address - Phone:202-808-8583
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-27
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty