Provider Demographics
NPI:1730270844
Name:HORTON, TIMOTHY (PHD)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:
Last Name:HORTON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 FAUNCE CORNER RD
Mailing Address - Street 2:SUITE 445
Mailing Address - City:NORTH DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02747-1260
Mailing Address - Country:US
Mailing Address - Phone:508-996-0443
Mailing Address - Fax:508-636-9172
Practice Address - Street 1:86 FAUNCE CORNER RD
Practice Address - Street 2:SUITE 445
Practice Address - City:NORTH DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-1260
Practice Address - Country:US
Practice Address - Phone:508-996-0443
Practice Address - Fax:508-636-9172
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4541103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical