Individual
STACY B HORNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
64 INDUSTRIAL PARK ROAD, PLYMOUTH, MA 02360
(508) 830-1630
Mailing address
64 INDUSTRIAL PARK ROAD, PLYMOUTH, MA 02360
(508) 830-1630
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110026265E
—
MA
01
—
685661
TUFTS
MA
Enumeration date
09/09/2010
Last updated
09/12/2012
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