=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184627010
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BARBARA THORNBERRY AU.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/24/2005
-----------------------------------------------------
Last Update Date | 04/06/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 330 N MARKET ST STE B
-----------------------------------------------------
City | LISBON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44432-1146
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-870-4601
-----------------------------------------------------
Fax | 330-870-4189
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 645409
-----------------------------------------------------
City | PITTSBURGH
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15264-5252
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-386-6442
-----------------------------------------------------
Fax | 330-386-3660
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 231H00000X
-----------------------------------------------------
Taxonomy Name | Audiologist
-----------------------------------------------------
License Number | A-0954
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------