Provider Demographics
NPI:1053411470
Name:HORN, BILL ROBERT (PHD)
Entity type:Individual
Prefix:DR
First Name:BILL
Middle Name:ROBERT
Last Name:HORN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 SACHEM RD
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-7230
Mailing Address - Country:US
Mailing Address - Phone:203-327-5021
Mailing Address - Fax:203-861-2294
Practice Address - Street 1:1767 SUMMER ST
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5115
Practice Address - Country:US
Practice Address - Phone:203-327-5021
Practice Address - Fax:203-861-2294
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1111103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist