Provider Demographics
NPI:1346535135
Name:COJOCARU, STEPHANIE TABITHA
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:TABITHA
Last Name:COJOCARU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 3RD ST N STE 101
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-3818
Mailing Address - Country:US
Mailing Address - Phone:773-573-3300
Mailing Address - Fax:
Practice Address - Street 1:233 3RD ST N STE 101
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-3818
Practice Address - Country:US
Practice Address - Phone:773-573-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-09
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY9609103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical