Provider Demographics
NPI:1144076027
Name:HORNER, ABBIGAIL (RBT)
Entity type:Individual
Prefix:
First Name:ABBIGAIL
Middle Name:
Last Name:HORNER
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 21ST AVE S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-5321
Mailing Address - Country:US
Mailing Address - Phone:701-630-8795
Mailing Address - Fax:
Practice Address - Street 1:602 21ST AVE S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-5321
Practice Address - Country:US
Practice Address - Phone:701-630-8795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-30
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician