Patricia Jean Kolanko-Brown, LSCW

Individual provider Active NPI Clinical Social Worker · Macdill Afb, FL

NPI 1699769810 · NPPES record last updated Jul 17, 2008

Key facts

NPI
1699769810
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
SW 0003715 (FL)
Practice address
8415 Bayshore Blvd
Macdill Afb, FL 33621-1607
Phone
(813) 827-9183
Fax
(813) 828-6868
NPI assigned
Sep 2, 2005
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
SW 0003715FLMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW 0003715 FL Yes

Addresses

Primary practice location

8415 Bayshore Blvd
Macdill Afb, FL 33621-1607

Mailing address

5910 N Kenneth Ave
Tampa, FL 33604-6518
Phone (813) 827-9183

Other providers in Macdill Afb, FL

All providers in Macdill Afb, FL · Clinical Social Worker in Florida

Sources for this page

Verify at the official NPI Registry.