Doctor Name: | MRS. TARA WEST HORNE |
NPI Number: | 1295773968 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 4585 |
Business Practice Address: | 1012 S Blackstock Rd Landrum, SC - 293569136 |
Business Phone Number: | 8644574208 |
Business Fax Number: | |
Mailing Address: | 106 Wild Heather Dr, CAMPOBELLO |
State: | SC |
Postal Code: | 293227800 |
Phone Number: | 8644684247 |
Fax Number: | |
NPI Enumeration Date: | 06/03/2006 |
NPI Last Update Date: | 01/23/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 4585 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |