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General NPI Number Information
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NPI Number | 1083234090
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Entity Type | Individual
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Provider Name | GREGORY PAUL NORMAN
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Gender | Male
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Dates
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Enumeration Date | 04/20/2020
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Last Update Date | 04/20/2020
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Provider Practice Location Address
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Address Line | 9630 E SHEA BLVD
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-6267
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Country | US
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Telephone | 480-551-5420
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Fax |
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Provider Business Mailing Address
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Address Line | 2022 N 37TH PL
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City | PHOENIX
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State | AZ
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Zip | 85008-3007
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Country | US
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Telephone | 602-513-6317
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 6134
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License Number State | AZ
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