Provider Demographics
NPI:1609978006
Name:BROZYNA, MONIQUE (LMSW)
Entity Type:Individual
Prefix:MS
First Name:MONIQUE
Middle Name:
Last Name:BROZYNA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4221 W SPRUCE ST
Mailing Address - Street 2:2406
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-4174
Mailing Address - Country:US
Mailing Address - Phone:813-879-5452
Mailing Address - Fax:
Practice Address - Street 1:10,000 BAY PINES BLVD.
Practice Address - Street 2:122
Practice Address - City:ST.PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33744
Practice Address - Country:US
Practice Address - Phone:727-398-6661
Practice Address - Fax:727-319-1330
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010814161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical