Provider Demographics
NPI:1013975853
Name:THORNHILL, DENISE D (PHD)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:D
Last Name:THORNHILL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:DEBORAH
Other - Middle Name:DENISE
Other - Last Name:THORNHILL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:715 E 3900 S
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-2182
Mailing Address - Country:US
Mailing Address - Phone:801-261-5141
Mailing Address - Fax:801-261-5142
Practice Address - Street 1:715 E 3900 S
Practice Address - Street 2:SUITE 202
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84107-2182
Practice Address - Country:US
Practice Address - Phone:801-261-5141
Practice Address - Fax:801-261-5142
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-02
Last Update Date:2009-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT332378-2501103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000061603Medicare PIN