MEDICARE: JANE C THORNTON

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	101YM0800X	Mental Health Counselor	12902301-3501	UT

General Provider Information

NPI Number	:	1689411936
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANE C THORNTON

Provider Business Mailing Address
First Line	:	105 E TURNER MILL RD
Second Line	:
City	:	HEBER CITY
State	:	UT
Zip	:	84032-4681
Country	:	US
Telephone Number	:	801-833-2083
Fax Number	:

Provider Business Practice Location Address
First Line	:	175 N MAIN ST STE 204
Second Line	:
City	:	HEBER CITY
State	:	UT
Zip	:	84032-1622
Country	:	US
Telephone Number	:	801-833-2083
Fax Number	:

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

Provider Enumeration Date	:	07/12/2024
Last Update Date	:	07/12/2024

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Directions to “ JANE C THORNTON ” Practice Location

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