Provider Demographics
NPI:1972906857
Name:HORNE-MOYER, HELEN LYNN (PHD)
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:LYNN
Last Name:HORNE-MOYER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:
Other - Last Name:HORNE-MOYER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:8616 MAIN ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-7461
Mailing Address - Country:US
Mailing Address - Phone:404-786-1524
Mailing Address - Fax:
Practice Address - Street 1:8616 MAIN ST
Practice Address - Street 2:SUITE 4
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-7461
Practice Address - Country:US
Practice Address - Phone:404-786-1524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-06
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017648-1103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist