Provider Demographics
NPI:1770325557
Name:HORTON, AMBER (FYTM-CES, RYT 200)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:HORTON
Suffix:
Gender:F
Credentials:FYTM-CES, RYT 200
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3655 SILVERY WAY
Mailing Address - Street 2:
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-1138
Mailing Address - Country:US
Mailing Address - Phone:404-480-8961
Mailing Address - Fax:
Practice Address - Street 1:3655 SILVERY WAY
Practice Address - Street 2:
Practice Address - City:POWDER SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30127-1138
Practice Address - Country:US
Practice Address - Phone:404-480-8961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-11
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAFYTM-CES171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Single Specialty