Provider Demographics
NPI:1346246816
Name:NORMAN, SALLY ANN (PHD)
Entity type:Individual
Prefix:
First Name:SALLY
Middle Name:ANN
Last Name:NORMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2360 SWEET HOME RD STE 1
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-2331
Mailing Address - Country:US
Mailing Address - Phone:716-622-6237
Mailing Address - Fax:844-907-2998
Practice Address - Street 1:2360 SWEET HOME RD STE 1
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228-2331
Practice Address - Country:US
Practice Address - Phone:716-622-6237
Practice Address - Fax:844-907-2998
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015362103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000527354002OtherHEALTH INTEGRATED
NY11515521OtherCAQH
NY00026192402OtherUNIVERA HEALTHCARE
NY6111583OtherINDEPENDENT HEALTH
NY000527354002OtherBC/BS OF WNY
NY6111583OtherINDEPENDENT HEALTH
NY00026192402OtherUNIVERA HEALTHCARE