Provider Demographics
NPI:1376640268
Name:NORRIS, GAYLIN LEA (LPC, LMFT)
Entity Type:Individual
Prefix:MS
First Name:GAYLIN
Middle Name:LEA
Last Name:NORRIS
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7744 BROADWAY ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-3225
Mailing Address - Country:US
Mailing Address - Phone:210-828-8781
Mailing Address - Fax:210-822-7542
Practice Address - Street 1:7744 BROADWAY ST
Practice Address - Street 2:SUITE 105
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-3225
Practice Address - Country:US
Practice Address - Phone:210-828-8781
Practice Address - Fax:210-822-7542
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2065101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional