Healthcare Provider Details

I. General information

NPI: 1740294941
Provider Name (Legal Business Name): WILLIAM H NORMAN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 11/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

580 TEN ROD RD
NORTH KINGSTOWN RI
02852-4220
US

IV. Provider business mailing address

580 TEN ROD RD
NORTH KINGSTOWN RI
02852-4220
US

V. Phone/Fax

Practice location:
  • Phone: 401-294-6170
  • Fax: 401-295-5255
Mailing address:
  • Phone: 401-294-6170
  • Fax: 401-295-5255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License NumberPS00158
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: