Provider Demographics
NPI:1326344656
Name:THORNBERRY, NATALIE R (PC)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:R
Last Name:THORNBERRY
Suffix:
Gender:F
Credentials:PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:282 W BOWERY ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44307-2598
Mailing Address - Country:US
Mailing Address - Phone:330-996-4600
Mailing Address - Fax:330-643-0767
Practice Address - Street 1:282 W BOWERY ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44307-2598
Practice Address - Country:US
Practice Address - Phone:330-996-4600
Practice Address - Fax:330-643-0767
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-03
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.0601008101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health