Individual
DONOVAN LAFON HORTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.C.S.W.
Contact information
Practice address
1585 3RD ST, FORT POLK, LA 71459
(601) 988-7513
Mailing address
270 SUNDOWN TRL, JACKSON, MS 39212-3211
(601) 372-3432
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
C4064
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C4064
LICENSED CERTIFIED SOCIAL WORKER
MS
Enumeration date
04/04/2007
Last updated
06/26/2018
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