Provider Demographics
NPI:1457695389
Name:NORRIS, REBEKAH (MS)
Entity Type:Individual
Prefix:MISS
First Name:REBEKAH
Middle Name:
Last Name:NORRIS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 CAMPBELL THICKETT RD
Mailing Address - Street 2:
Mailing Address - City:RIDGEVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29472-6339
Mailing Address - Country:US
Mailing Address - Phone:843-821-3073
Mailing Address - Fax:843-821-7459
Practice Address - Street 1:331 CAMPBELL THICKETT RD
Practice Address - Street 2:
Practice Address - City:RIDGEVILLE
Practice Address - State:SC
Practice Address - Zip Code:29472-6339
Practice Address - Country:US
Practice Address - Phone:843-821-3073
Practice Address - Fax:843-821-7459
Is Sole Proprietor?:No
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist