Provider Demographics
NPI:1134749054
Name:THORNTON, PATRICIA JO
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:JO
Last Name:THORNTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TRISHA
Other - Middle Name:JO
Other - Last Name:THORNTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3299 AZTECA TRL
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-1501
Mailing Address - Country:US
Mailing Address - Phone:915-996-1077
Mailing Address - Fax:888-526-0456
Practice Address - Street 1:3299 AZTECA TRL
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79938-1501
Practice Address - Country:US
Practice Address - Phone:915-996-1077
Practice Address - Fax:888-526-0456
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-21
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78204101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor