Provider Demographics
NPI:1942859947
Name:HORNE, BAILEY KATHLEEN (MOT)
Entity Type:Individual
Prefix:
First Name:BAILEY
Middle Name:KATHLEEN
Last Name:HORNE
Suffix:
Gender:F
Credentials:MOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050-3130
Mailing Address - Country:US
Mailing Address - Phone:609-607-7400
Mailing Address - Fax:609-488-5654
Practice Address - Street 1:950 HOOPER AVE UNIT 2
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-8319
Practice Address - Country:US
Practice Address - Phone:848-251-5355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-11
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00872300225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist