Provider Demographics
NPI:1447404710
Name:HORTON, CAROLYN (MS)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:HORTON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:
Other - Last Name:HEUER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS
Mailing Address - Street 1:100 N HUMPHREYS BLVD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-2146
Mailing Address - Country:US
Mailing Address - Phone:443-465-4513
Mailing Address - Fax:
Practice Address - Street 1:100 N HUMPHREYS BLVD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-2146
Practice Address - Country:US
Practice Address - Phone:443-465-4513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-12
Last Update Date:2012-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN29OtherTENNESSEE STATE LICENSE
14477OtherAMERICAN BOARD OF GENETIC COUNSELORS CERTIFICATION