Provider Demographics
NPI:1750055463
Name:NORTON-MASON, LAURA (EDS)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:NORTON-MASON
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 INVERNESS DR
Mailing Address - Street 2:
Mailing Address - City:DELRAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08075-1888
Mailing Address - Country:US
Mailing Address - Phone:609-304-2739
Mailing Address - Fax:
Practice Address - Street 1:36 INVERNESS DR
Practice Address - Street 2:
Practice Address - City:DELRAN
Practice Address - State:NJ
Practice Address - Zip Code:08075-1888
Practice Address - Country:US
Practice Address - Phone:609-304-2739
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-05
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool