Individual provider · Type 1 NPI

Penny Layne Nicole Thornburg

Mental Health Counselor · Salem, OR

NPI number 1295265437 Active

Practice location

3737 Portland Rd NE
Salem, OR 97301-0311

Fax (503) 485-8977

Mailing address

PO Box 20400
Keizer, OR 97307-0400

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1295265437

Penny Layne Nicole Thornburg's National Provider Identifier is 1295265437, issued on Jun 19, 2017. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Salem, OR. The record was last updated on Jun 19, 2017.