Provider Demographics
NPI:1942212337
Name:HORTON, NANCY ELLEN (MS, AMFT)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:ELLEN
Last Name:HORTON
Suffix:
Gender:F
Credentials:MS, AMFT
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:ELLEN
Other - Last Name:LARSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:31 S EDGELAWN DR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-4301
Mailing Address - Country:US
Mailing Address - Phone:708-535-7320
Mailing Address - Fax:708-535-7571
Practice Address - Street 1:31 S EDGELAWN DR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-4301
Practice Address - Country:US
Practice Address - Phone:708-535-7320
Practice Address - Fax:708-535-7571
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist