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General NPI Number Information
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NPI Number | 1609978006
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Entity Type | Individual
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Provider Name | MONIQUE BROZYNA LMSW
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Gender | Female
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Dates
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Enumeration Date | 09/05/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 10,000 BAY PINES BLVD. 122
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City | ST.PETERSBURG
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State | FL
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Zip | 33744
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Country | US
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Telephone | 727-398-6661
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Fax | 727-319-1330
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Provider Business Mailing Address
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Address Line | 4221 W SPRUCE ST 2406
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City | TAMPA
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State | FL
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Zip | 33607-4174
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Country | US
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Telephone | 813-879-5452
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801081416
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License Number State | MI
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