Individual
MS. WYLENA NELL THORNTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.D.T.
Contact information
Practice address
14513 BENSLEY AVE, BURHAM, IL 60633-2205
(708) 730-3328
(708) 730-0710
Mailing address
14513 BENSLEY AVE, BURHAM, IL 60633-2205
(708) 730-3328
(708) 730-0710
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
08/04/2006
Last updated
07/08/2007
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