Provider Demographics
NPI:1770392318
Name:VANHORN, MASON MALONE
Entity type:Individual
Prefix:
First Name:MASON
Middle Name:MALONE
Last Name:VANHORN
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 1:1067 33RD ST APT 202
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50311-3832
Mailing Address - Country:US
Mailing Address - Phone:515-745-6107
Mailing Address - Fax:
Practice Address - Street 1:950 28TH AVE SW STE 200
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:IA
Practice Address - Zip Code:50009-3939
Practice Address - Country:US
Practice Address - Phone:515-446-2075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician