Provider Demographics
NPI:1396862777
Name:PIORKOWSKI, KRYSTYNA JOZEFA (PHD,MALMHC)
Entity Type:Individual
Prefix:MRS
First Name:KRYSTYNA
Middle Name:JOZEFA
Last Name:PIORKOWSKI
Suffix:
Gender:F
Credentials:PHD,MALMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MIRABELLA CIR
Mailing Address - Street 2:UNIT 204
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34292-2493
Mailing Address - Country:US
Mailing Address - Phone:941-504-9251
Mailing Address - Fax:941-412-3047
Practice Address - Street 1:333 TAMIAMI TRL S
Practice Address - Street 2:SUITE 103
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-2402
Practice Address - Country:US
Practice Address - Phone:941-484-0766
Practice Address - Fax:941-412-3047
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH6403101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health