Provider Demographics
NPI:1851124648
Name:HORN, ISAAC (LCGC)
Entity type:Individual
Prefix:
First Name:ISAAC
Middle Name:
Last Name:HORN
Suffix:
Gender:M
Credentials:LCGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7607 FOREST AVE STE S00
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-4913
Mailing Address - Country:US
Mailing Address - Phone:804-545-7991
Mailing Address - Fax:
Practice Address - Street 1:7607 FOREST AVE STE 200
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-4913
Practice Address - Country:US
Practice Address - Phone:804-545-7991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0139000741170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS