Provider Demographics
NPI:1669148227
Name:THORNTON, MEREDITH (BA)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:
Last Name:THORNTON
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:928 ENRIGHT AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45205-1766
Mailing Address - Country:US
Mailing Address - Phone:513-206-0173
Mailing Address - Fax:
Practice Address - Street 1:1 MOOCK RD STE 101
Practice Address - Street 2:
Practice Address - City:WILDER
Practice Address - State:KY
Practice Address - Zip Code:41071-5465
Practice Address - Country:US
Practice Address - Phone:859-341-9333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator