Provider Demographics
NPI:1730433616
Name:BROSIUS, JOSHUA (MDIV)
Entity type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:
Last Name:BROSIUS
Suffix:
Gender:M
Credentials:MDIV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 NE 25TH AVE STE 306
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34470-4885
Mailing Address - Country:US
Mailing Address - Phone:352-671-7884
Mailing Address - Fax:
Practice Address - Street 1:1601 NE 25TH AVE STE 306
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-4885
Practice Address - Country:US
Practice Address - Phone:352-671-7884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-31
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor