Individual
GENEA THORNTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7085 WILLOWWOOD ST, ORLANDO, FL 32818-5855
(407) 273-1997
Mailing address
9406 EGRET COVE CT, ORLANDO, FL 32825-7559
(407) 273-1997
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
172V00000X
Community Health Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
270791440
—
FL
Enumeration date
06/29/2016
Last updated
06/29/2016
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