Provider Demographics
NPI:1629532353
Name:THORNTON, VERONICA A (PHD)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:A
Last Name:THORNTON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-293-4969
Mailing Address - Fax:614-293-6111
Practice Address - Street 1:480 MEDICAL CENTER DR FL 1
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1229
Practice Address - Country:US
Practice Address - Phone:614-293-4969
Practice Address - Fax:614-293-6111
Is Sole Proprietor?:No
Enumeration Date:2019-01-28
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY10273103G00000X
OHP.08545103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist