Provider Demographics
NPI:1316982598
Name:HORN, KATHLEEN RAY (MS, OTR/L)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:RAY
Last Name:HORN
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 358353
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32635-8353
Mailing Address - Country:US
Mailing Address - Phone:352-278-2586
Mailing Address - Fax:
Practice Address - Street 1:1601 SW ARCHER RD # 151C
Practice Address - Street 2:ROOM E554-1
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-1135
Practice Address - Country:US
Practice Address - Phone:352-376-1611
Practice Address - Fax:352-271-4551
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT9313225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist