Provider Demographics
NPI:1992392559
Name:NORWOOD, THERESA
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:
Last Name:NORWOOD
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 1:919 CHRISTY BLVD
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:OH
Mailing Address - Zip Code:43420-4523
Mailing Address - Country:US
Mailing Address - Phone:419-559-9102
Mailing Address - Fax:
Practice Address - Street 1:1508 NORTH ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:OH
Practice Address - Zip Code:43420-5111
Practice Address - Country:US
Practice Address - Phone:419-559-9102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health