Provider Demographics
NPI:1326299165
Name:BRZOZOWSKI, LAURA JEAN (MA)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:JEAN
Last Name:BRZOZOWSKI
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 CRISP MORNING CT
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77382-5797
Mailing Address - Country:US
Mailing Address - Phone:832-813-7463
Mailing Address - Fax:
Practice Address - Street 1:118 CRISP MORNING CT
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77382-5797
Practice Address - Country:US
Practice Address - Phone:832-813-7463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-09
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9956101YM0800X
TX4157106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health