Provider Demographics
NPI:1962635938
Name:LAWRENCE, PATRINA MAY (MSW)
Entity Type:Individual
Prefix:MRS
First Name:PATRINA
Middle Name:MAY
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 PEACE DR
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34759-5432
Mailing Address - Country:US
Mailing Address - Phone:863-496-5151
Mailing Address - Fax:863-496-5151
Practice Address - Street 1:510 PEACE DR
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34759-5432
Practice Address - Country:US
Practice Address - Phone:863-496-1239
Practice Address - Fax:863-496-1239
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-25
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500781631041C0700X
FLSW 96121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical