Provider Demographics
NPI:1316621188
Name:THORNTON, KASEY LOUISE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:KASEY
Middle Name:LOUISE
Last Name:THORNTON
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 YORKSHIRE ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-7016
Mailing Address - Country:US
Mailing Address - Phone:304-320-0663
Mailing Address - Fax:
Practice Address - Street 1:405 YORKSHIRE ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-7016
Practice Address - Country:US
Practice Address - Phone:304-320-0663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-12
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist