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General NPI Number Information
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NPI Number | 1457571929
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Entity Type | Individual
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Provider Name | EMILY TERESE NORRIS D.T.
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Gender | Female
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1428 W LAFAYETTE ST
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City | OTTAWA
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State | IL
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Zip | 61350-1761
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Country | US
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Telephone | 815-343-6824
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Fax |
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Provider Business Mailing Address
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Address Line | 1428 W LAFAYETTE ST
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City | OTTAWA
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State | IL
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Zip | 61350-1761
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Country | US
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Telephone | 815-343-6824
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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 | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number | EZ65610802P
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License Number State | IL
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