Provider Demographics
NPI:1245803311
Name:NORMAN, JENNIFER LEE (PEER SUPPORTER)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LEE
Last Name:NORMAN
Suffix:
Gender:F
Credentials:PEER SUPPORTER
Other - Prefix:MISS
Other - First Name:JENNIFER
Other - Middle Name:LEE
Other - Last Name:MURRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:N/A
Mailing Address - Street 1:759 COLUMBUS AVE
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-1754
Mailing Address - Country:US
Mailing Address - Phone:513-932-4337
Mailing Address - Fax:513-932-6750
Practice Address - Street 1:759 COLUMBUS AVE
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45036-1754
Practice Address - Country:US
Practice Address - Phone:513-932-4337
Practice Address - Fax:513-932-6750
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-19
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist