Provider Demographics
NPI:1851182653
Name:THORNTON, FATIMA MICHELLE (HHWC)
Entity type:Individual
Prefix:
First Name:FATIMA
Middle Name:MICHELLE
Last Name:THORNTON
Suffix:
Gender:F
Credentials:HHWC
Other - Prefix:
Other - First Name:FATIMA
Other - Middle Name:MICHELLE
Other - Last Name:NEALY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4819 S KACHINA DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-7343
Mailing Address - Country:US
Mailing Address - Phone:480-652-0115
Mailing Address - Fax:
Practice Address - Street 1:4819 S KACHINA DR
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7343
Practice Address - Country:US
Practice Address - Phone:480-652-0115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Single Specialty