Doctor Name: | JACQUELINE ANN NORVELL |
NPI Number: | 1003033788 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 107 N Main St Kingfisher, OK - 737502720 |
Business Phone Number: | 4053753735 |
Business Fax Number: | |
Mailing Address: | 4155 Terrace Hls Nw, PIEDMONT |
State: | OK |
Postal Code: | 730787414 |
Phone Number: | 4059223997 |
Fax Number: | |
NPI Enumeration Date: | 04/20/2007 |
NPI Last Update Date: | 12/31/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |