Provider Demographics
NPI:1053430934
Name:VANHORN, DELLA LATINA
Entity type:Individual
Prefix:MRS
First Name:DELLA
Middle Name:LATINA
Last Name:VANHORN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 HONEYSUCKLE WAY
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:AL
Mailing Address - Zip Code:35135-1025
Mailing Address - Country:US
Mailing Address - Phone:205-352-4690
Mailing Address - Fax:
Practice Address - Street 1:105 JOHNSON AVE N
Practice Address - Street 2:
Practice Address - City:TALLADEGA
Practice Address - State:AL
Practice Address - Zip Code:35160-2464
Practice Address - Country:US
Practice Address - Phone:256-362-7716
Practice Address - Fax:256-362-7715
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2168237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist