Provider Demographics
NPI:1366772865
Name:NORRIS, PAUL (PHD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:NORRIS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 FISHER POND RD
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:VT
Mailing Address - Zip Code:05478-6286
Mailing Address - Country:US
Mailing Address - Phone:802-524-6555
Mailing Address - Fax:802-524-6562
Practice Address - Street 1:107 FISHER POND RD
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:VT
Practice Address - Zip Code:05478-6286
Practice Address - Country:US
Practice Address - Phone:802-524-6555
Practice Address - Fax:802-524-6562
Is Sole Proprietor?:No
Enumeration Date:2010-01-05
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0480108741103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical