Provider Demographics
NPI:1235972993
Name:NORRIS, DAIJAH DUVONNE (OT)
Entity type:Individual
Prefix:
First Name:DAIJAH
Middle Name:DUVONNE
Last Name:NORRIS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 CROWN ARCH
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-3417
Mailing Address - Country:US
Mailing Address - Phone:757-735-1588
Mailing Address - Fax:
Practice Address - Street 1:220 CROWN ARCH
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-3417
Practice Address - Country:US
Practice Address - Phone:757-735-1588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-18
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119010544225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics