Healthcare Provider Details

I. General information

NPI: 1386557585
Provider Name (Legal Business Name): HELEN THORN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 WEST ST
GENEVA NY
14456-2521
US

IV. Provider business mailing address

221 MASON ST LOWR UNIT
CANANDAIGUA NY
14424-1680
US

V. Phone/Fax

Practice location:
  • Phone: 315-781-0406
  • Fax:
Mailing address:
  • Phone: 336-944-1788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number037158
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: