Provider Demographics
NPI:1003139742
Name:PENDLETON, NORWOOD E (NBC-HIS MS)
Entity Type:Individual
Prefix:MR
First Name:NORWOOD
Middle Name:E
Last Name:PENDLETON
Suffix:
Gender:M
Credentials:NBC-HIS MS
Other - Prefix:MR
Other - First Name:TRENT
Other - Middle Name:
Other - Last Name:HEBDON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NBA-HIS-BS
Mailing Address - Street 1:1410 N HILL FIELD RD STE 5
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-5056
Mailing Address - Country:US
Mailing Address - Phone:801-668-6479
Mailing Address - Fax:801-317-4076
Practice Address - Street 1:1410 N HILL FIELD RD STE 5
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-5056
Practice Address - Country:US
Practice Address - Phone:801-668-6479
Practice Address - Fax:801-317-4076
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-09
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1061044601237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist