Provider Demographics
NPI:1477442689
Name:HORN, ERROL MONTY
Entity type:Individual
Prefix:
First Name:ERROL
Middle Name:MONTY
Last Name:HORN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9136 W BERKELEY RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85037-4387
Mailing Address - Country:US
Mailing Address - Phone:205-253-8914
Mailing Address - Fax:
Practice Address - Street 1:7012 N 56TH AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85301-2516
Practice Address - Country:US
Practice Address - Phone:602-877-3931
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician