Provider Demographics
NPI:1972031391
Name:DR BRENT HORNER LLC
Entity Type:Organization
Organization Name:DR BRENT HORNER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:HORNER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:541-206-7080
Mailing Address - Street 1:132 E BROADWAY STE 301
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3154
Mailing Address - Country:US
Mailing Address - Phone:541-206-7080
Mailing Address - Fax:888-978-7650
Practice Address - Street 1:132 E BROADWAY STE 301
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3154
Practice Address - Country:US
Practice Address - Phone:541-206-7080
Practice Address - Fax:888-978-7650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty