Provider Demographics
NPI:1427487503
Name:NORRIS, ALYSSA (COTA/L)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:NORRIS
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:
Other - Last Name:WENIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA/L
Mailing Address - Street 1:2961 MOYER LN
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-4707
Mailing Address - Country:US
Mailing Address - Phone:740-262-3486
Mailing Address - Fax:
Practice Address - Street 1:2961 MOYER LN
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-4707
Practice Address - Country:US
Practice Address - Phone:740-262-3486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-08
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOTA.05399224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant