Provider Demographics
NPI:1417741927
Name:NORRIS, SANDRA E
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:E
Last Name:NORRIS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3925 BIRKEMEIER DR
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63034-2104
Mailing Address - Country:US
Mailing Address - Phone:314-614-4902
Mailing Address - Fax:
Practice Address - Street 1:5101 MCREE AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-2019
Practice Address - Country:US
Practice Address - Phone:314-776-3300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO235Z00000X
MOLIFETIME235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist