Provider Demographics
NPI:1881195980
Name:HORN, JESSICA
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:HORN
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 1:1840 W EMELITA AVE
Mailing Address - Street 2:2056
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-4035
Mailing Address - Country:US
Mailing Address - Phone:480-215-5773
Mailing Address - Fax:
Practice Address - Street 1:31645 N ROYAL OAK WAY
Practice Address - Street 2:
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85143-6341
Practice Address - Country:US
Practice Address - Phone:480-677-3349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-23
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant