Healthcare Provider Details

I. General information

NPI: 1356489926
Provider Name (Legal Business Name): GAYLE SHARYN NORBURY PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: 0 0

II. Dates (important events)

Enumeration Date: 02/03/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 STADIUM DRIVE
HATTIESBURG MS
39401-0000
US

IV. Provider business mailing address

PO BOX 1729
HATTIESBURG MS
39403-1729
US

V. Phone/Fax

Practice location:
  • Phone: 601-450-0310
  • Fax: 601-450-0231
Mailing address:
  • Phone: 601-545-8700
  • Fax: 601-582-5461

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number46752
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: