Provider Demographics
NPI:1235530965
Name:THORNTON, JOANNE W (MA, MS, MBA)
Entity Type:Individual
Prefix:MRS
First Name:JOANNE
Middle Name:W
Last Name:THORNTON
Suffix:
Gender:F
Credentials:MA, MS, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42654 FRONTIER DRIVE
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20148
Mailing Address - Country:US
Mailing Address - Phone:703-489-7876
Mailing Address - Fax:
Practice Address - Street 1:42654 FRONTIER DR
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20148-7207
Practice Address - Country:US
Practice Address - Phone:703-489-7876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-12
Last Update Date:2014-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC5903101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional