Healthcare Provider Details

I. General information

NPI: 1255451431
Provider Name (Legal Business Name): JUDITH MARY NORMAN MS, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 08/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3491 S EVANS ST STE A
GREENVILLE NC
27834-4534
US

IV. Provider business mailing address

3491 S EVANS ST STE A
GREENVILLE NC
27834-4534
US

V. Phone/Fax

Practice location:
  • Phone: 252-227-1577
  • Fax: 252-321-7840
Mailing address:
  • Phone: 252-227-1577
  • Fax: 252-321-7840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number5380
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: