Provider Demographics
NPI:1508041294
Name:ISOM-NORMAN, DANNETTE AMIEL
Entity Type:Individual
Prefix:MRS
First Name:DANNETTE
Middle Name:AMIEL
Last Name:ISOM-NORMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 25042
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93729-5042
Mailing Address - Country:US
Mailing Address - Phone:559-547-7570
Mailing Address - Fax:559-892-4550
Practice Address - Street 1:5321 N FRESNO ST STE 108
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-6850
Practice Address - Country:US
Practice Address - Phone:559-547-7570
Practice Address - Fax:559-892-4550
Is Sole Proprietor?:No
Enumeration Date:2008-01-01
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health