Provider Demographics
NPI:1821701137
Name:HORN, PARKER
Entity Type:Individual
Prefix:
First Name:PARKER
Middle Name:
Last Name:HORN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7986 TIMBER PEAK LN
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-1829
Mailing Address - Country:US
Mailing Address - Phone:702-477-9295
Mailing Address - Fax:
Practice Address - Street 1:3850 W ANN RD STE 120
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031-4407
Practice Address - Country:US
Practice Address - Phone:702-323-6555
Practice Address - Fax:702-323-6613
Is Sole Proprietor?:No
Enumeration Date:2023-01-02
Last Update Date:2023-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician