Provider Demographics
NPI:1720237936
Name:NORMAN, LAMONICA ANTOINETTE (BA)
Entity Type:Individual
Prefix:MRS
First Name:LAMONICA
Middle Name:ANTOINETTE
Last Name:NORMAN
Suffix:
Gender:F
Credentials:BA
Other - Prefix:MISS
Other - First Name:LAMONICA
Other - Middle Name:ANTOINETTE
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:3206 MAPLE HILL DR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38118-1726
Mailing Address - Country:US
Mailing Address - Phone:901-794-7144
Mailing Address - Fax:901-369-1433
Practice Address - Street 1:3810 WINCHESTER RD
Practice Address - Street 2:SOUTHEAST MENTAL HEALTH
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38118-6045
Practice Address - Country:US
Practice Address - Phone:901-369-1420
Practice Address - Fax:901-369-1420
Is Sole Proprietor?:No
Enumeration Date:2008-09-11
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator