Provider Demographics
NPI:1093863581
Name:DUNN FIERSTEIN, PATRICIA MARIE (LCSW)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:MARIE
Last Name:DUNN FIERSTEIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1612 BEACHWAY LN
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:FL
Mailing Address - Zip Code:33556-5512
Mailing Address - Country:US
Mailing Address - Phone:813-253-3797
Mailing Address - Fax:813-920-0394
Practice Address - Street 1:2124 W KENNEDY BLVD STE C
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-1545
Practice Address - Country:US
Practice Address - Phone:813-253-3797
Practice Address - Fax:813-920-0394
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW-15751041C0700X
FLSW 15751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical