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General NPI Number Information
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NPI Number | 1336963271
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Entity Type | Individual
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Provider Name | PRECIOUS THORNTON
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Gender | Female
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Dates
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Enumeration Date | 11/07/2024
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Last Update Date | 01/03/2025
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Provider Practice Location Address
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Address Line | 18021 FAWN TREE DR
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City | LITTLE ROCK
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State | AR
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Zip | 72210-7123
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Country | US
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Telephone | 870-898-0376
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Fax |
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Provider Business Mailing Address
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Address Line | 4813 RIDGE RD STE 111
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City | DOUGLASVILLE
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State | GA
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Zip | 30134-6167
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Country | US
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Telephone | 870-898-0376
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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 | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number | 177288
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License Number State | AR
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