Provider Demographics
NPI:1649530171
Name:NORRELL, ERIN BUTLER (MCD-CCC-SLP)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:BUTLER
Last Name:NORRELL
Suffix:
Gender:F
Credentials:MCD-CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1794 COVINGTON RDG
Mailing Address - Street 2:UNIT 1402
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-6684
Mailing Address - Country:US
Mailing Address - Phone:256-810-9534
Mailing Address - Fax:
Practice Address - Street 1:2450 VILLAGE PROFESSIONAL DR N
Practice Address - Street 2:
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-4734
Practice Address - Country:US
Practice Address - Phone:334-528-1964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-17
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3169282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL636000526Medicaid