Provider Demographics
NPI:1972113181
Name:SURPRIS, NORMA
Entity Type:Individual
Prefix:MS
First Name:NORMA
Middle Name:
Last Name:SURPRIS
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 1:148 LINDEN ST STE 208
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02482-7916
Mailing Address - Country:US
Mailing Address - Phone:781-239-0290
Mailing Address - Fax:781-235-6819
Practice Address - Street 1:148 LINDEN ST STE 208
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02482-7916
Practice Address - Country:US
Practice Address - Phone:781-239-0290
Practice Address - Fax:781-235-6819
Is Sole Proprietor?:No
Enumeration Date:2020-08-03
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker