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General NPI Number Information
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NPI Number | 1053655365
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Entity Type | Individual
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Provider Name | GINA LINNET NORRIS M.A., LLPC
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Gender | Female
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Dates
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Enumeration Date | 11/27/2012
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Last Update Date | 11/27/2012
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Provider Practice Location Address
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Address Line | 17356 WEST TWELVE MILE ROAD, SUITE 203 PERSONAL CHOICE PLANNED CHANGE HUMAN SERVICES LLC
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City | SOUTHFIELD
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State | MI
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Zip | 48076
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Country | US
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Telephone | 248-363-1976
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Fax | 248-481-3794
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Provider Business Mailing Address
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Address Line | 11373 WHITCOMB ST
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City | DETROIT
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State | MI
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Zip | 48227-2013
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Country | US
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Telephone | 313-980-4022
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 6401012901
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License Number State | MI
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