| NPI | 1669964029 |
|---|---|
| Former Name | THEA LORAINE NORRIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: OH P.07728) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: OH P.07728) |
| Enumeration Date | 2018-06-01 |
| Last Update Date | 2019-05-24 |