Provider Demographics
NPI:1467736306
Name:THORNTON, AMANDA MARIE (AU D)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:MARIE
Last Name:THORNTON
Suffix:
Gender:F
Credentials:AU D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6399 KELLY CT
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21703-8656
Mailing Address - Country:US
Mailing Address - Phone:240-446-8544
Mailing Address - Fax:
Practice Address - Street 1:9300 DEWITT LOOP, SUNRISE PAVILION, SECOND FLOOR
Practice Address - Street 2:FORT BELVOIR COMMUNITY HOSPITAL
Practice Address - City:FORT BELVIOR
Practice Address - State:VA
Practice Address - Zip Code:22060-1298
Practice Address - Country:US
Practice Address - Phone:571-231-2725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-10
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8013696-4101231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist