Provider Demographics
NPI:1730805391
Name:THORNTON, MARY ELIZABETH (CNP)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:ELIZABETH
Last Name:THORNTON
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:E
Other - Last Name:THORNTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:386 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:MA
Mailing Address - Zip Code:01867-1209
Mailing Address - Country:US
Mailing Address - Phone:781-258-3044
Mailing Address - Fax:
Practice Address - Street 1:386 GROVE ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:MA
Practice Address - Zip Code:01867-1209
Practice Address - Country:US
Practice Address - Phone:781-258-3044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-17
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2674212084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry