Individual
MR. DALLAS PAUL NORMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LPC, NCC
Contact information
Practice address
3830 S CUSHMAN ST, FAIRBANKS, AK 99701-7530
(907) 455-5238
Mailing address
5582 CASCADE RD, FAIRBANKS, AK 99709-5811
(907) 455-5238
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
782
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MH0157
—
AK
Enumeration date
12/07/2012
Last updated
12/07/2012
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