Provider Demographics
NPI:1487080164
Name:HORSPOOL, ALICIA MARIE (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:MARIE
Last Name:HORSPOOL
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:MARIE
Other - Last Name:WIMMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, OTR/L
Mailing Address - Street 1:413 ELMHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:VESTAL
Mailing Address - State:NY
Mailing Address - Zip Code:13850-1408
Mailing Address - Country:US
Mailing Address - Phone:570-396-4424
Mailing Address - Fax:
Practice Address - Street 1:413 ELMHAVEN DR
Practice Address - Street 2:
Practice Address - City:VESTAL
Practice Address - State:NY
Practice Address - Zip Code:13850-1408
Practice Address - Country:US
Practice Address - Phone:570-396-4424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-25
Last Update Date:2017-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018293-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist