Individual
JENNIFER THORNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D, BCBA-D
Contact information
Practice address
1018 N BRAGG BLVD, SPRING LAKE, NC 28390-3316
(910) 295-2609
Mailing address
1018 N BRAGG BLVD, SPRING LAKE, NC 28390-3316
(917) 657-1056
(919) 869-1685
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-08-4723
NC
Other
Enumeration date
06/22/2016
Last updated
11/20/2018
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