Individual
DAVID BROCKWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D
Contact information
Practice address
3730 18TH AVE N, ST PETERSBURG, FL 33713-4816
(727) 666-2429
Mailing address
3730 18TH AVE N, ST PETERSBURG, FL 33713-4816
(727) 666-2429
Taxonomy
Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
102L00000X
VT
103T00000X
Psychologist
Primary
0471010316
FL
Other
Enumeration date
11/15/2014
Last updated
05/19/2016
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