Provider Demographics
NPI:1013038363
Name:CROSBY, MARLENA SUSAN (BS)
Entity Type:Individual
Prefix:MS
First Name:MARLENA
Middle Name:SUSAN
Last Name:CROSBY
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4425 PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-3540
Mailing Address - Country:US
Mailing Address - Phone:727-547-0607
Mailing Address - Fax:727-547-6752
Practice Address - Street 1:4425 PARK BLVD
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-3540
Practice Address - Country:US
Practice Address - Phone:727-547-0607
Practice Address - Fax:727-547-6752
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker