MEDICARE: NANCY THORNTON

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
1	1041C0700X	Clinical Social Worker	6801081963	MI

General Provider Information

NPI Number	:	1538457817
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY THORNTON

Provider Business Mailing Address
First Line	:	1431 ROOSEVELT
Second Line	:
City	:	YPSILANTI
State	:	MI
Zip	:	48197-2034
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	37899 W 12 MILE RD
Second Line	:	SUITE 130
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48331-3048
Country	:	US
Telephone Number	:	248-476-2229
Fax Number	:	248-476-4434

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2011
Last Update Date	:	07/20/2011

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Directions to “ NANCY THORNTON ” Practice Location

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