Provider Demographics
NPI:1528374659
Name:NORRIS, TAMARA SUZANN (OTR)
Entity Type:Individual
Prefix:MRS
First Name:TAMARA
Middle Name:SUZANN
Last Name:NORRIS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:614 5TH ST
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:KS
Mailing Address - Zip Code:66771-4012
Mailing Address - Country:US
Mailing Address - Phone:620-778-2784
Mailing Address - Fax:
Practice Address - Street 1:614 5TH ST
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:KS
Practice Address - Zip Code:66771-4012
Practice Address - Country:US
Practice Address - Phone:620-778-2784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-26
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-02225225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist