Individual
JACQUELINE RENA HORNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
11 DAIRY LANE, FREDERICKSBURG, VA 22404
(540) 371-9414
Mailing address
518 PLEASANTS DR., FREDERICKSBURG, VA 22407
(540) 898-7163
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1021124
VA
Other
Enumeration date
03/19/2007
Last updated
07/08/2007
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