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General NPI Number Information
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NPI Number | 1508577669
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Entity Type | Individual
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Provider Name | JENNIFER LEA NORMA M.ED., BCBA, LBA
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Gender | Female
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Dates
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Enumeration Date | 12/09/2022
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Last Update Date | 12/09/2022
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Provider Practice Location Address
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Address Line | 416 CAMPBELL AVE SW STE 103
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City | ROANOKE
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State | VA
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Zip | 24016-3627
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Country | US
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Telephone | 540-366-7399
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Fax |
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Provider Business Mailing Address
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Address Line | 416 CAMPBELL AVE SW STE 103
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City | ROANOKE
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State | VA
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Zip | 24016-3627
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Country | US
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Telephone |
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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