Provider Demographics
NPI:1801403761
Name:NORRIS, JESSICA LEE
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:LEE
Last Name:NORRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ARROYO MARINOS, BARRANCO DE LA CRUZ, MANZANA 4, 28
Mailing Address - Street 2:
Mailing Address - City:ALMUNECAR
Mailing Address - State:GRANADA
Mailing Address - Zip Code:18690
Mailing Address - Country:ES
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:ARROYO MARINOS, BARRANCO DE LA CRUZ, MANZANA 4
Practice Address - Street 2:NUMERO 28
Practice Address - City:ALMUNECAR
Practice Address - State:GRANADA
Practice Address - Zip Code:18690
Practice Address - Country:ES
Practice Address - Phone:978-895-8688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-25
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101004920235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist