Provider Demographics
NPI:1366891277
Name:VAN HORN, ANNETTE STRICKLAND (PSYD)
Entity type:Individual
Prefix:DR
First Name:ANNETTE
Middle Name:STRICKLAND
Last Name:VAN HORN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:ANNETTE
Other - Middle Name:
Other - Last Name:STRICKLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:460 TOWN PLAZA AVE
Mailing Address - Street 2:SUITE 230
Mailing Address - City:PONTE VEDRA
Mailing Address - State:FL
Mailing Address - Zip Code:32081-0574
Mailing Address - Country:US
Mailing Address - Phone:904-297-5565
Mailing Address - Fax:
Practice Address - Street 1:460 TOWN PLAZA AVE
Practice Address - Street 2:SUITE 230
Practice Address - City:PONTE VEDRA
Practice Address - State:FL
Practice Address - Zip Code:32081-0574
Practice Address - Country:US
Practice Address - Phone:904-297-5565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-10
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 9218103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical