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General NPI Number Information
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NPI Number | 1013692094
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Entity Type | Individual
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Provider Name | ESHANA THORNTON RBT
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Gender | Female
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Dates
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Enumeration Date | 06/19/2023
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Last Update Date | 07/03/2025
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Provider Practice Location Address
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Address Line | 601 S LAKE DESTINY RD STE 350
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City | MAITLAND
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State | FL
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Zip | 32751-7222
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Country | US
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Telephone | 443-527-0040
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Fax |
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Provider Business Mailing Address
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Address Line | 606 CORAL GLEN LOOP APT 207
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-1741
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Country | US
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Telephone | 443-527-0040
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-23-270994
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License Number State | GA
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