Healthcare Provider Details

I. General information

NPI: 1184991671
Provider Name (Legal Business Name): CHRISTINE NORRIS LADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2011
Last Update Date: 11/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 HANOVER ST
MANCHESTER NH
03103
US

IV. Provider business mailing address

127 STINSON RD
GOFFSTOWN NH
03045
US

V. Phone/Fax

Practice location:
  • Phone: 603-622-3020
  • Fax: 603-622-4043
Mailing address:
  • Phone: 603-486-2659
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number814
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: