Provider Demographics
NPI:1477097525
Name:NORVELL, DEVA (OTRL)
Entity Type:Individual
Prefix:
First Name:DEVA
Middle Name:
Last Name:NORVELL
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1075 E 4TH ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40741-2528
Mailing Address - Country:US
Mailing Address - Phone:606-682-9579
Mailing Address - Fax:
Practice Address - Street 1:1075 E 4TH ST
Practice Address - Street 2:SUITE 2
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741-2528
Practice Address - Country:US
Practice Address - Phone:606-682-9579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-08
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY131866225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist