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NPI 1396553921

NPI 1396553921 : ERICA NORBERG LMT : WARREN, RI

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General NPI Number Information
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    NPI Number           |    1396553921
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    Entity Type          |    Individual 
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    Provider Name        |    ERICA NORBERG LMT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/30/2024
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    Last Update Date     |    12/30/2024
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Provider Practice Location Address
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    Address Line         |    11 MILL ST APT 1 
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    City                 |    WARREN
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    State                |    RI
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    Zip                  |    02885-2407
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    Country              |    US
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    Telephone            |    401-252-1519
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    11 MILL ST APT 1 
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    City                 |    WARREN
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    State                |    RI
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    Zip                  |    02885-2407
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    Country              |    US
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    Telephone            |    401-252-1519
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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        |    225700000X
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    Taxonomy Name        |    Massage Therapist
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    License Number       |    18212-MT-MT
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    License Number State |    MA
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Taxonomy #2
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    Taxonomy Code        |    225700000X
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    Taxonomy Name        |    Massage Therapist
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    License Number       |    MT02483
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    License Number State |    RI
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