Provider Demographics
NPI:1578700498
Name:ASENCIO, NORMA F (MS)
Entity Type:Individual
Prefix:
First Name:NORMA
Middle Name:F
Last Name:ASENCIO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3188 PGA BLVD STE 1436
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-2802
Mailing Address - Country:US
Mailing Address - Phone:561-624-6648
Mailing Address - Fax:561-624-6570
Practice Address - Street 1:3188 PGA BLVD STE 1436
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-2802
Practice Address - Country:US
Practice Address - Phone:561-624-6648
Practice Address - Fax:561-624-6570
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-14
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH4393101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health