Provider Demographics
NPI:1447867726
Name:HORTON, WHITNEY TAYLOR (M ED, BCBA, LBA)
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:TAYLOR
Last Name:HORTON
Suffix:
Gender:F
Credentials:M ED, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:935 WILCOX CT STE 110
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-5170
Mailing Address - Country:US
Mailing Address - Phone:423-863-4042
Mailing Address - Fax:423-407-0354
Practice Address - Street 1:935 WILCOX CT STE 110
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-5170
Practice Address - Country:US
Practice Address - Phone:423-863-4042
Practice Address - Fax:423-407-0354
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-30
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-21-56258103K00000X
VA0133002844103K00000X
TN0000939103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1447867726Medicaid
TN1447867726Medicaid