Provider Demographics
NPI:1851165104
Name:NORFORD, JANET VERONICA (BCABA 0-14-1368)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:VERONICA
Last Name:NORFORD
Suffix:
Gender:F
Credentials:BCABA 0-14-1368
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4125 ROSEMAN BRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-1262
Mailing Address - Country:US
Mailing Address - Phone:678-512-9771
Mailing Address - Fax:
Practice Address - Street 1:25 POINTE RIDGE DR
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-2755
Practice Address - Country:US
Practice Address - Phone:833-354-7722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0-14-1368106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Single Specialty