Kibra La'Tise Vanhorn
Rehabilitation Practitioner in Benton Harbor, MI. Individual provider (NPI-1).
NPI number1043106982
StatusActive
Last updated in NPPESSep 11, 2025
Details
- NPI
- 1043106982
- Entity type
- Individual (NPI-1)
- Name
- Kibra La'Tise Vanhorn
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 17, 2025
- Certification date
- Jun 17, 2025
- Last updated
- Sep 11, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225400000X | Rehabilitation Practitioner | 1012128 | CA | Yes |
Other names
- Kibra L Vanhorn-Williams (Other Name)
Practice location
185 E Main St Ste 405Benton Harbor, MI 49022-4432
Phone 269-588-1119
Mailing address
1388 Saint Thomas St Unit BBenton Harbor, MI 49022-3908
Phone 269-861-1169
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