Provider Demographics
NPI:1649576240
Name:NORMAN, SALENA MARIE (ISW)
Entity type:Individual
Prefix:
First Name:SALENA
Middle Name:MARIE
Last Name:NORMAN
Suffix:
Gender:F
Credentials:ISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6153 METROWEST BLVD UNIT 107
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-2993
Mailing Address - Country:US
Mailing Address - Phone:407-495-3159
Mailing Address - Fax:
Practice Address - Street 1:517 DELTONA BLVD STE A
Practice Address - Street 2:
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32725-8016
Practice Address - Country:US
Practice Address - Phone:386-473-4566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-31
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW 57261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical