Provider Demographics
NPI:1043745946
Name:NORRIS, STEPHANIE (MED, BCBA, LABA)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:NORRIS
Suffix:
Gender:F
Credentials:MED, BCBA, LABA
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:COLOZZO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:M ED, BCBA, LABA
Mailing Address - Street 1:99 S MAIN ST STE 10
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02721-5349
Mailing Address - Country:US
Mailing Address - Phone:508-444-8938
Mailing Address - Fax:
Practice Address - Street 1:439 S UNION ST STE 116
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843-2837
Practice Address - Country:US
Practice Address - Phone:978-655-9064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-27
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
222Q00000X
MA3929103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist