Provider Demographics
NPI:1144258278
Name:NORRIS, WENDY C (MSAT,C)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:C
Last Name:NORRIS
Suffix:
Gender:F
Credentials:MSAT,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9348 CHERRY HILL RD
Mailing Address - Street 2:APT. 105
Mailing Address - City:COLLEGE PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20740-1241
Mailing Address - Country:US
Mailing Address - Phone:301-366-3259
Mailing Address - Fax:
Practice Address - Street 1:DEMATHA HIGH SCHOOL
Practice Address - Street 2:4313 MADISON ST.
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20781
Practice Address - Country:US
Practice Address - Phone:301-864-3666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer