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Individual

LAURA AMANDA THORNTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
C.T.R.S.

Contact information

Practice address
22170 W 9 MILE RD, SOUTHFIELD, MI 48033-6007
(248) 372-6800
Mailing address
44441 SAVERY DR, CANTON, MI 48187-2929
(765) 250-0189

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
MI
225800000X
Recreation Therapist
62059
MI

Other

Enumeration date
02/06/2013
Last updated
10/05/2020
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