Provider Demographics
NPI:1306376454
Name:HORNER, CHRISTINE ELLEN RENEE (MA, BCBA)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ELLEN RENEE
Last Name:HORNER
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 HOBBS REESOR RD
Mailing Address - Street 2:
Mailing Address - City:VINE GROVE
Mailing Address - State:KY
Mailing Address - Zip Code:40175-7302
Mailing Address - Country:US
Mailing Address - Phone:478-227-4428
Mailing Address - Fax:888-690-5532
Practice Address - Street 1:209 HOBBS REESOR RD
Practice Address - Street 2:
Practice Address - City:VINE GROVE
Practice Address - State:KY
Practice Address - Zip Code:40175-7302
Practice Address - Country:US
Practice Address - Phone:478-227-4428
Practice Address - Fax:888-690-5532
Is Sole Proprietor?:No
Enumeration Date:2017-06-12
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4001103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY245130OtherLICENSED BEHAVIOR ANALYST
KY1-18-31523OtherBCBA ONLY
NC1909OtherLICENSED BEHAVIOR ANALYST
VA0133002733OtherLICENSED BEHAVIOR ANALYST
TX4001OtherLICENSED BEHAVIOR ANALYST