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NPI Code Detail

MEDICARE: LEAH THORNTON CDCA

MEDICARE: LEAH THORNTON CDCA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor173746OH

General Provider Information

NPI Number : 1376169276
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEAH THORNTON CDCA
Provider Business Mailing Address
First Line : 1215 1ST AVE
Second Line :
City : MIDDLETOWN
State : OH
Zip : 45044-4117
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1215 1ST AVE
Second Line :
City : MIDDLETOWN
State : OH
Zip : 45044-4117
Country : US
Telephone Number : 916-256-7542
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2020
Last Update Date : 06/17/2020

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Directions to “ LEAH THORNTON CDCA” Practice Location

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