Individual
THERESA M NORMOYLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
2690 NE KRESKY AVE, CHEHALIS, WA 98532-2412
(360) 330-9595
(360) 330-9560
Mailing address
2690 NE KRESKY AVE, CHEHALIS, WA 98532-2412
(360) 330-9595
(360) 330-9560
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CL60160627
WA
101YM0800X
Mental Health Counselor
LH60432436
WA
103T00000X
Psychologist
Primary
PY60128025
WA
103TC0700X
Clinical Psychologist
PY60128025
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2040196
—
WA
Enumeration date
03/13/2013
Last updated
12/22/2016
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