Provider Demographics
NPI:1467761387
Name:THORNEY, ALECIA KERRY-ANN (LMT)
Entity Type:Individual
Prefix:MRS
First Name:ALECIA
Middle Name:KERRY-ANN
Last Name:THORNEY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MRS
Other - First Name:ALECIA
Other - Middle Name:KERRY-ANN
Other - Last Name:MOLANO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:130 MAHOPAC AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:GRANITE SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:10527-1131
Mailing Address - Country:US
Mailing Address - Phone:914-875-9082
Mailing Address - Fax:888-223-9564
Practice Address - Street 1:130 MAHOPAC AVE APT 3
Practice Address - Street 2:
Practice Address - City:GRANITE SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:10527-1131
Practice Address - Country:US
Practice Address - Phone:914-875-9082
Practice Address - Fax:888-223-9564
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-27
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017102-1225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1467761387OtherMASSAGE THERAPY