Basic Information
| Provider Information | |||||||||
| NPI: | 1609990316 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HORNE | ||||||||
| FirstName: | DAWN | ||||||||
| MiddleName: | C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 27320 INDEPENDENCE LN | ||||||||
| Address2: | |||||||||
| City: | SALISBURY | ||||||||
| State: | MD | ||||||||
| PostalCode: | 218011707 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4436142456 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6040 PUBLIC LANDING RD | ||||||||
| Address2: | |||||||||
| City: | SNOW HILL | ||||||||
| State: | MD | ||||||||
| PostalCode: | 218632453 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4106321100 | ||||||||
| FaxNumber: | 4107425810 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/19/2007 | ||||||||
| LastUpdateDate: | 08/29/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/29/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
ID Information
| ID | Type | State | Issuer | Description | 705371101 | 05 | MD | MEDICAID |