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1487990826
GWENDOLYN LAVORN HORTON
DYER, IN
NPI
1487990826
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: IN 87000621A)
Enumeration Date
2012-12-12
Last Update Date
2021-03-13
Business Address
GWENDOLYN LAVORN HORTON MHS, LCAC
24 JOLIET ST
DYER, IN 46311-1705
Phone number: 219-865-2141
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Mailing Address
GWENDOLYN LAVORN HORTON MHS, LCAC
PO BOX 781076
DETROIT, MI 48278-1076
Phone number: 317-528-4800
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