Provider Demographics
NPI:1356574776
Name:HORN, ANGELA KAYE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:KAYE
Last Name:HORN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:KAYE
Other - Last Name:MATTHEWS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3007 BROOKWOOD CT
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-7537
Mailing Address - Country:US
Mailing Address - Phone:214-734-3193
Mailing Address - Fax:
Practice Address - Street 1:1900 CROWLEY PRIDE DR
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:TX
Practice Address - Zip Code:76036-8535
Practice Address - Country:US
Practice Address - Phone:817-297-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-02
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104509235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist