Provider Demographics
NPI:1154868875
Name:HORSEY, JAMES
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:HORSEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 GOODPORT LANE
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878
Mailing Address - Country:US
Mailing Address - Phone:240-694-8377
Mailing Address - Fax:
Practice Address - Street 1:32 GOODPORT LN
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-1059
Practice Address - Country:US
Practice Address - Phone:240-694-8377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-20
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician