Provider Demographics
NPI:1104960269
Name:RYEN, NORMA (MSW)
Entity type:Individual
Prefix:
First Name:NORMA
Middle Name:
Last Name:RYEN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1704 WEST 26TH STREET
Mailing Address - Street 2:16508-1234
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16504-1858
Mailing Address - Country:US
Mailing Address - Phone:814-452-1178
Mailing Address - Fax:814-452-2258
Practice Address - Street 1:1704 W 26TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16508-1234
Practice Address - Country:US
Practice Address - Phone:814-452-1178
Practice Address - Fax:814-452-2258
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW006349L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical