Individual
MS. BRANDY SUZANNE FORMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1012 E SILVER SPRINGS BLVD STE B7&8, OCALA, FL 34470-6781
(352) 405-0789
Mailing address
1309 SE 43RD AVE, OCALA, FL 34471-4944
(352) 843-6222
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW11920
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SW11920
LICENSED CLINICAL SOCIAL WORKER - LCSW
FL
Enumeration date
09/01/2021
Last updated
08/03/2022
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