Provider Demographics
NPI:1871256073
Name:THORNTON-WOURMS, EMILY LOUISE
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:LOUISE
Last Name:THORNTON-WOURMS
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 1:40 W LONG ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-2817
Mailing Address - Country:US
Mailing Address - Phone:220-465-5327
Mailing Address - Fax:
Practice Address - Street 1:40 W LONG ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-2817
Practice Address - Country:US
Practice Address - Phone:220-465-5327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-15
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator