Provider Demographics
NPI:1942407531
Name:THORNE, COURTNEY (OTR)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:THORNE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5191 WELLINGTON PARK CIR
Mailing Address - Street 2:APT CH7
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32839-4586
Mailing Address - Country:US
Mailing Address - Phone:321-276-8203
Mailing Address - Fax:
Practice Address - Street 1:5191 WELLINGTON PARK CIR
Practice Address - Street 2:APT CH7
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32839-4586
Practice Address - Country:US
Practice Address - Phone:321-276-8203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11423225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist