Provider Demographics
NPI:1063589463
Name:NORTON, GERENE HAMILTON (MS CCC SLP CCCA)
Entity type:Individual
Prefix:MS
First Name:GERENE
Middle Name:HAMILTON
Last Name:NORTON
Suffix:
Gender:F
Credentials:MS CCC SLP CCCA
Other - Prefix:
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Mailing Address - Street 1:8140 W SILKWOOD CT
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-0714
Mailing Address - Country:US
Mailing Address - Phone:208-373-1723
Mailing Address - Fax:
Practice Address - Street 1:12301 W EXPLORER DR
Practice Address - Street 2:SUITE 102
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83713-1571
Practice Address - Country:US
Practice Address - Phone:208-373-1723
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDAUD-1282231H00000X
IDSLP-1281235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist