Healthcare Provider Details

I. General information

NPI: 1235398900
Provider Name (Legal Business Name): SHAUNA R NORRIE MOT OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2008
Last Update Date: 11/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 N 9TH ST
BISMARCK ND
58501-4515
US

IV. Provider business mailing address

3925 SHERIDAN DR
AMHERST NY
14226-1738
US

V. Phone/Fax

Practice location:
  • Phone: 701-530-8800
  • Fax: 701-751-4550
Mailing address:
  • Phone: 716-250-6492
  • Fax: 716-250-4178

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number1057
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: