Provider Demographics
NPI:1730340431
Name:HORTON, NAOMI SABRINA (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:NAOMI
Middle Name:SABRINA
Last Name:HORTON
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2933 W ROCK RIVER RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CRAWFORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47933-5026
Mailing Address - Country:US
Mailing Address - Phone:765-366-8568
Mailing Address - Fax:
Practice Address - Street 1:4740 KINGSWAY DR STE 33
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46205-1521
Practice Address - Country:US
Practice Address - Phone:317-828-0211
Practice Address - Fax:888-887-0932
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-24
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22003934A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200675350OtherLEGACY PROVIDER IDENTIFIER (LPI)
IN200730540 AOtherLEGACY PROVIDER IDENTIFIER (LPI)