Doctor Name: | MR. ROBERT HUNTER THORN |
NPI Number: | 1689840829 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | BA,CSC-AD |
License Number: | SC0970 |
Business Practice Address: | 5980 Cullen Dr Sabillasville, MD - 217809702 |
Business Phone Number: | 2404205400 |
Business Fax Number: | |
Mailing Address: | 5980 Cullen Dr, SABILLASVILLE |
State: | MD |
Postal Code: | 217809702 |
Phone Number: | 2404205400 |
Fax Number: | |
NPI Enumeration Date: | 05/07/2008 |
NPI Last Update Date: | 05/07/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | SC0970 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |