Provider Demographics
NPI:1780943738
Name:NORBURY, ANGELA KAY (BSE)
Entity type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:KAY
Last Name:NORBURY
Suffix:
Gender:F
Credentials:BSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 SEQUOYAH ST
Mailing Address - Street 2:
Mailing Address - City:TALIHINA
Mailing Address - State:OK
Mailing Address - Zip Code:74571
Mailing Address - Country:US
Mailing Address - Phone:918-917-3771
Mailing Address - Fax:
Practice Address - Street 1:205 DEWEY AVE STE 2
Practice Address - Street 2:
Practice Address - City:POTEAU
Practice Address - State:OK
Practice Address - Zip Code:74953-4224
Practice Address - Country:US
Practice Address - Phone:918-917-3771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-11
Last Update Date:2012-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation