Provider Demographics
NPI:1699016410
Name:NORWOOD, JONATHAN ANDREW (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:ANDREW
Last Name:NORWOOD
Suffix:
Gender:M
Credentials:PSYD
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 1108
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76503-1108
Mailing Address - Country:US
Mailing Address - Phone:254-773-4022
Mailing Address - Fax:
Practice Address - Street 1:2201 S W S YOUNG DR
Practice Address - Street 2:SUITE 116A
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76543-5317
Practice Address - Country:US
Practice Address - Phone:254-773-4022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-04
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36090103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical