Provider Demographics
NPI:1437235124
Name:NORVELL, ROSA LYNN (COTA)
Entity Type:Individual
Prefix:MS
First Name:ROSA
Middle Name:LYNN
Last Name:NORVELL
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 1:67 OAKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BURLISON
Mailing Address - State:TN
Mailing Address - Zip Code:38015-6397
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1992 HIGHWAY 51 S
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:TN
Practice Address - Zip Code:38019-3623
Practice Address - Country:US
Practice Address - Phone:901-384-9752
Practice Address - Fax:901-384-9762
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1125224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant