Provider Demographics
NPI:1194414144
Name:THORNTON, ZARIA
Entity type:Individual
Prefix:
First Name:ZARIA
Middle Name:
Last Name:THORNTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4209 LINDSEY DR # ANANA
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30035-1926
Mailing Address - Country:US
Mailing Address - Phone:470-437-7868
Mailing Address - Fax:
Practice Address - Street 1:4209 LINDSEY DR # ANANA
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30035-1926
Practice Address - Country:US
Practice Address - Phone:470-437-7868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician