MEDICARE: KRISTY NORRIS LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	305	KS

General Provider Information

NPI Number	:	1942234646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTY NORRIS LMFT

Provider Business Mailing Address
First Line	:	209 TRAVIS ST STE 105
Second Line	:
City	:	ROANOKE
State	:	TX
Zip	:	76262-8605
Country	:	US
Telephone Number	:	214-998-9252
Fax Number	:

Provider Business Practice Location Address
First Line	:	209 TRAVIS ST STE 105
Second Line	:
City	:	ROANOKE
State	:	TX
Zip	:	76262-8605
Country	:	US
Telephone Number	:	214-998-9252
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	07/28/2020

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