MEDICARE: NAOMI S THORNTON L.C.S.W.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	1016	MT

General Provider Information

NPI Number	:	1548542095
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAOMI S THORNTON L.C.S.W.

Provider Business Mailing Address
First Line	:	800 KENSINGTON AVE STE 211A
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59801-5670
Country	:	US
Telephone Number	:	406-544-1278
Fax Number	:	406-552-4877

Provider Business Practice Location Address
First Line	:	800 KENSINGTON AVE STE 211A
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59801-5670
Country	:	US
Telephone Number	:	406-544-1278
Fax Number	:	406-552-4877

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/11/2011
Last Update Date	:	05/26/2016

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