Provider Demographics
NPI:1265769681
Name:HORN, BRIANNE (CCC,SLP, MS)
Entity type:Individual
Prefix:
First Name:BRIANNE
Middle Name:
Last Name:HORN
Suffix:
Gender:F
Credentials:CCC,SLP, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6138 DITTO RD
Mailing Address - Street 2:
Mailing Address - City:PHILPOT
Mailing Address - State:KY
Mailing Address - Zip Code:42366-9056
Mailing Address - Country:US
Mailing Address - Phone:270-993-7775
Mailing Address - Fax:
Practice Address - Street 1:6138 DITTO RD
Practice Address - Street 2:
Practice Address - City:PHILPOT
Practice Address - State:KY
Practice Address - Zip Code:42366-9056
Practice Address - Country:US
Practice Address - Phone:270-993-7775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-05
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY138295235Z00000X
KY3663235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist