Individual
FANITA LAKAYE JACKSON-NORMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
551 NATIONAL HEALTH CARE DR, DAYTONA BEACH, FL 32114-1495
(386) 323-7530
Mailing address
589 S INDIGO RD, ALTAMONTE SPRINGS, FL 32714-3197
(407) 463-5500
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW0004175
FL
Other
Enumeration date
07/19/2006
Last updated
07/08/2007
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