Provider Demographics
NPI:1912625583
Name:DR. SHARON MAHOWALD-HORNER, PLLC
Entity Type:Organization
Organization Name:DR. SHARON MAHOWALD-HORNER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:MAHOWALD-HORNER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:952-395-1483
Mailing Address - Street 1:9337 WOODRIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:SAVAGE
Mailing Address - State:MN
Mailing Address - Zip Code:55378-3153
Mailing Address - Country:US
Mailing Address - Phone:952-210-0681
Mailing Address - Fax:
Practice Address - Street 1:9337 WOODRIDGE CIR
Practice Address - Street 2:
Practice Address - City:SAVAGE
Practice Address - State:MN
Practice Address - Zip Code:55378-3153
Practice Address - Country:US
Practice Address - Phone:952-210-0681
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-18
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty