Doctor Name: | MR. GLEN ALLEN HORST |
NPI Number: | 1881843043 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 42035 47th St W Quartz Hill, CA - 935363502 |
Business Phone Number: | 6619432317 |
Business Fax Number: | |
Mailing Address: | 42035 47th St W, QUARTZ HILL |
State: | CA |
Postal Code: | 935363502 |
Phone Number: | 6619432317 |
Fax Number: | |
NPI Enumeration Date: | 09/12/2008 |
NPI Last Update Date: | 09/12/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |