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Individual

THOMAS FLETCHER THORNTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LISW

Contact information

Practice address
1601-A ST. MICHAEL'S DR., SANTA FE, NM 87505-1601
(509) 429-1462
Mailing address
P.O. BOX 2062, LAS VEGAS, NM 87701-2062
(505) 429-1462

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-1512
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
78558
NM
Enumeration date
01/03/2008
Last updated
01/03/2008
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