Provider Demographics
NPI:1386484798
Name:NORRIS, LILLIAN GRACE
Entity type:Individual
Prefix:
First Name:LILLIAN
Middle Name:GRACE
Last Name:NORRIS
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 1:200 W MIDDLETON ST
Mailing Address - Street 2:
Mailing Address - City:ORLEANS
Mailing Address - State:IN
Mailing Address - Zip Code:47452-9201
Mailing Address - Country:US
Mailing Address - Phone:812-653-0838
Mailing Address - Fax:
Practice Address - Street 1:1408 S WALNUT ST
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47401-5887
Practice Address - Country:US
Practice Address - Phone:812-653-0838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-31
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker