Provider Demographics
NPI:1407165574
Name:HARRIS, NORMA (COTA)
Entity Type:Individual
Prefix:
First Name:NORMA
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:DOWNS
Mailing Address - State:KS
Mailing Address - Zip Code:67437-1728
Mailing Address - Country:US
Mailing Address - Phone:785-545-6071
Mailing Address - Fax:
Practice Address - Street 1:610 DIVISION ST
Practice Address - Street 2:
Practice Address - City:DOWNS
Practice Address - State:KS
Practice Address - Zip Code:67437-1728
Practice Address - Country:US
Practice Address - Phone:785-545-6071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-06
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS18-00362224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant