Individual
DR. CHARLES ANDREW THORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1044 BELMONT AVE, YOUNGSTOWN, OH 44504-1006
(330) 480-3679
(330) 480-3748
Mailing address
1044 BELMONT AVE, YOUNGSTOWN, OH 44504-1006
(330) 480-3679
(330) 480-3748
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
1834
NC
103T00000X
Psychologist
Primary
2156
OH
103T00000X
Psychologist
PS002919L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0372403
—
OH
01
—
H141370
MEDICARE PTAN
OH
Enumeration date
09/26/2006
Last updated
02/05/2017
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