Provider Information for 1386989903
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Mr. DALLAS PAUL NORMAN MS, LPC, NCC
Sex: Male
NPI: 1386989903
Last Updated: 2012-12-07
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1386989903 | ||||||||
| Enumeration Date | 2012-12-07 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 5582 CASCADE RD FAIRBANKS, AK 99709-5811 United States Phone: 907-455-5238 | Fax: | ||||||||
| Primary Practice Address | 3830 S CUSHMAN ST FAIRBANKS, AK 99701-7530 United States Phone: 907-455-5238 | Fax: | ||||||||
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