Provider Demographics
NPI:1467766469
Name:NORRIS, JEANNE A T (SLP)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:A T
Last Name:NORRIS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 205
Mailing Address - Street 2:
Mailing Address - City:SALUDA
Mailing Address - State:VA
Mailing Address - Zip Code:23149-0205
Mailing Address - Country:US
Mailing Address - Phone:804-758-2277
Mailing Address - Fax:
Practice Address - Street 1:2911 GENERAL PULLER HWY
Practice Address - Street 2:
Practice Address - City:SALUDA
Practice Address - State:VA
Practice Address - Zip Code:23149-3052
Practice Address - Country:US
Practice Address - Phone:804-815-8329
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-02
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202006073235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA493302OtherMEDICARE A
VA004909976Medicaid