Provider Demographics
NPI:1023127743
Name:NORBERG, JANE R (BA)
Entity type:Individual
Prefix:MS
First Name:JANE
Middle Name:R
Last Name:NORBERG
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 AVENUE B
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290-2842
Mailing Address - Country:US
Mailing Address - Phone:360-568-9863
Mailing Address - Fax:425-349-7256
Practice Address - Street 1:221 AVENUE B
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290-2840
Practice Address - Country:US
Practice Address - Phone:425-349-7266
Practice Address - Fax:425-349-7256
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00013637101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health