Provider Demographics
NPI:1356010037
Name:THORNE, AURELIA FAYE
Entity Type:Individual
Prefix:MRS
First Name:AURELIA
Middle Name:FAYE
Last Name:THORNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 13TH AVE N
Mailing Address - Street 2:
Mailing Address - City:BUHL
Mailing Address - State:ID
Mailing Address - Zip Code:83316-1515
Mailing Address - Country:US
Mailing Address - Phone:208-308-0158
Mailing Address - Fax:
Practice Address - Street 1:520 13TH AVE N
Practice Address - Street 2:
Practice Address - City:BUHL
Practice Address - State:ID
Practice Address - Zip Code:83316-1515
Practice Address - Country:US
Practice Address - Phone:208-308-0158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-07
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician