| Doctor Name: | JENNIFER LYNNE HORNICK |
| NPI Number: | 1740401447 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | BA, BSW, LSW |
| License Number: | AP00940521 |
| Business Practice Address: | Rr 1 Box 256a Triadelphia, WV - 260599725 |
| Business Phone Number: | 3045479197 |
| Business Fax Number: | 3045479198 |
| Mailing Address: | Po Box 24, BEECH BOTTOM |
| State: | WV |
| Postal Code: | 260300024 |
| Phone Number: | 3043945466 |
| Fax Number: | |
| NPI Enumeration Date: | 05/01/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | AP00940521 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |