Provider Demographics
NPI:1154659282
Name:NORVELL, KATHERINE REBECCA
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:REBECCA
Last Name:NORVELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4942 TYROLEAN AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63109-3760
Mailing Address - Country:US
Mailing Address - Phone:314-772-6933
Mailing Address - Fax:314-772-5858
Practice Address - Street 1:5389 ARSENAL ST
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63139-1401
Practice Address - Country:US
Practice Address - Phone:314-772-6933
Practice Address - Fax:314-772-5858
Is Sole Proprietor?:No
Enumeration Date:2009-12-01
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst