Provider Demographics
NPI:1194574426
Name:NORTON, JERRIN
Entity type:Individual
Prefix:
First Name:JERRIN
Middle Name:
Last Name:NORTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8232 WINNSBORO RD
Mailing Address - Street 2:
Mailing Address - City:BLYTHEWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29016-8876
Mailing Address - Country:US
Mailing Address - Phone:803-572-7638
Mailing Address - Fax:
Practice Address - Street 1:186 SEVEN FARMS DR STE F
Practice Address - Street 2:
Practice Address - City:DANIEL ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29492-8522
Practice Address - Country:US
Practice Address - Phone:803-814-3812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-17
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8379235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist