Doctor Name: | JOHN THORN |
NPI Number: | 1063837748 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 4916 National Rd Clayton, OH - 453159714 |
Business Phone Number: | 9378326025 |
Business Fax Number: | |
Mailing Address: | 4916 West National Road, CLAYTON |
State: | OH |
Postal Code: | 45315 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 03/04/2014 |
NPI Last Update Date: | 03/04/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TS0200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | School |
Taxonomy Definition: |