Provider Demographics
NPI:1942503453
Name:NORTON, JAN RENAE (PSYD)
Entity Type:Individual
Prefix:MS
First Name:JAN
Middle Name:RENAE
Last Name:NORTON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:793 DELTA AVE.
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45226
Mailing Address - Country:US
Mailing Address - Phone:513-205-6543
Mailing Address - Fax:513-871-4297
Practice Address - Street 1:793 DELTA AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45226
Practice Address - Country:US
Practice Address - Phone:513-205-6543
Practice Address - Fax:513-871-4297
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-06
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3822103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical