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Individual

KIM MARIE THURSTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DR

Contact information

Practice address
1003 PENNSYLVANIA AVE W, WARREN, PA 16365-1876
(814) 817-1400
(814) 817-1447
Mailing address
800 E MAIN ST, BRADFORD, PA 16701-3278
(814) 817-1400
(814) 817-1447

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS019851
PA

Other

Enumeration date
08/14/2023
Last updated
08/14/2023
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