MEDICARE: EMILY 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	175T00000X	Peer Specialist

General Provider Information

NPI Number	:	1750239463
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY THORNTON

Provider Business Mailing Address
First Line	:	2408 NW 112TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-7222
Country	:	US
Telephone Number	:	580-340-7752
Fax Number	:

Provider Business Practice Location Address
First Line	:	2408 NW 112TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-7222
Country	:	US
Telephone Number	:	580-340-7752
Fax Number	:

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

Provider Enumeration Date	:	03/18/2026
Last Update Date	:	03/18/2026

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Directions to “ EMILY THORNTON ” Practice Location

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