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General NPI Number Information
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NPI Number | 1891850848
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Entity Type | Individual
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Provider Name | STUART KENNETH NORRIS LMFT
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Gender | Male
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 209 EASTERN AVE
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City | AUGUSTA
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State | ME
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Zip | 04330-5951
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Country | US
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Telephone | 207-215-7527
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Fax |
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Provider Business Mailing Address
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Address Line | 53 WINDSOR AVE
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City | AUGUSTA
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State | ME
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Zip | 04330-5919
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Country | US
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Telephone | 207-626-3234
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MF 1977
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License Number State | ME
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