Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 11344 | LA |
NPI | 1003196189 |
---|---|
Provider Name | Shannon B Norris |
First Address | Clinton, LA 70722-0395 |
Second Address | Clinton, LA 70722-3710 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2011 |
Last Update Date | 22/08/2011 |