Provider Demographics
NPI:1225492275
Name:THORNTON, CHRISTINA (BCBA)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:THORNTON
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7345 NW 148TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73142-7859
Mailing Address - Country:US
Mailing Address - Phone:714-614-2716
Mailing Address - Fax:
Practice Address - Street 1:600 W 18TH ST
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-3631
Practice Address - Country:US
Practice Address - Phone:714-614-2716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-06
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1-16-22038103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst