Individual
KEN A NORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
2600 OAKLAND AVE, ELKHART, IN 46517-1533
(574) 533-1234
(574) 537-2652
Mailing address
330 LAKEVIEW DR, GOSHEN, IN 46528-9365
(574) 533-1234
(574) 537-2652
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
104100000X
Social Worker
33001138A
IN
Other
Enumeration date
06/26/2006
Last updated
08/08/2011
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