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General NPI Number Information
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NPI Number | 1285423764
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Entity Type | Individual
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Provider Name | LATORIA KYANA THORNTON MSW
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Gender | Female
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Dates
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Enumeration Date | 05/02/2025
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Last Update Date | 05/02/2025
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Provider Practice Location Address
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Address Line | 6100 RADIO STATION RD
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City | LA PLATA
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State | MD
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Zip | 20646-3314
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Country | US
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Telephone | 434-941-3486
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Fax |
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Provider Business Mailing Address
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Address Line | 2009 SAINT THOMAS DR APT 402
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City | WALDORF
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State | MD
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Zip | 20602-2177
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Country | US
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Telephone | 434-941-3486
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Fax | 434-941-3486
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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 | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | 30776
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License Number State | MD
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