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Individual

MRS. BEVERLY JEAN HORTON

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
463 S. LAKE POWELL BLVD, PAGE, AZ 86040
(928) 645-5113
Mailing address
PO BOX 790, PAGE, AZ 86040-0790
(928) 645-5113
(928) 645-3254

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-2210
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
832841
AZ
01
LPC-2210
AZ. BOARD OF BEHAVIORAL H
AZ
Enumeration date
04/19/2006
Last updated
07/09/2007
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