Provider Demographics
NPI:1053570663
Name:CONNOR, ROSEMARIE GLENNIE (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:ROSEMARIE
Middle Name:GLENNIE
Last Name:CONNOR
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4818 24TH AVE S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33711-3316
Mailing Address - Country:US
Mailing Address - Phone:813-777-5197
Mailing Address - Fax:
Practice Address - Street 1:4818 24TH AVE S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33711-3316
Practice Address - Country:US
Practice Address - Phone:813-777-5197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-09
Last Update Date:2010-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW85481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical