Provider Demographics
NPI:1275657652
Name:NORRIS, WENDY ELAINE (SLP)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:ELAINE
Last Name:NORRIS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28631 QUAILHILL DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO PALOS VERDES
Mailing Address - State:CA
Mailing Address - Zip Code:90275-3345
Mailing Address - Country:US
Mailing Address - Phone:310-990-3530
Mailing Address - Fax:
Practice Address - Street 1:28631 QUAILHILL DR
Practice Address - Street 2:
Practice Address - City:RANCHO PALOS VERDES
Practice Address - State:CA
Practice Address - Zip Code:90275-3345
Practice Address - Country:US
Practice Address - Phone:310-990-3530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4602235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist