Provider Demographics
NPI:1841815735
Name:THORNTON, HANNAH JANE
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:JANE
Last Name:THORNTON
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 1:344 E 100 S
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84111-1700
Mailing Address - Country:US
Mailing Address - Phone:801-322-3222
Mailing Address - Fax:
Practice Address - Street 1:672 E VINE ST STE 1
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-5539
Practice Address - Country:US
Practice Address - Phone:385-715-0233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-16
Last Update Date:2024-08-24
Deactivation Date:2024-06-03
Deactivation Code:
Reactivation Date:2024-08-19
Provider Licenses
StateLicense IDTaxonomies
171M00000X
UT13398655-35021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator