Provider Demographics
NPI:1699769810
Name:KOLANKO-BROWN, PATRICIA JEAN (LSCW)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:JEAN
Last Name:KOLANKO-BROWN
Suffix:
Gender:F
Credentials:LSCW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5910 N KENNETH AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33604-6518
Mailing Address - Country:US
Mailing Address - Phone:813-827-9183
Mailing Address - Fax:813-828-6868
Practice Address - Street 1:8415 BAYSHORE BLVD
Practice Address - Street 2:
Practice Address - City:MACDILL AFB
Practice Address - State:FL
Practice Address - Zip Code:33621-1607
Practice Address - Country:US
Practice Address - Phone:813-827-9183
Practice Address - Fax:813-828-6868
Is Sole Proprietor?:No
Enumeration Date:2005-09-02
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 00037151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical