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NPI Code Detail

MEDICARE: DIANGELIA BROWN

MEDICARE: DIANGELIA BROWN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1205265691
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANGELIA BROWN
Provider Business Mailing Address
First Line : 121 SALEM CHURCH RD
Second Line :
City : CLIMAX
State : GA
Zip : 39834-2428
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 198 S MACARTHUR DR
Second Line :
City : CAMILLA
State : GA
Zip : 31730-6370
Country : US
Telephone Number : 229-336-2247
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/05/2013
Last Update Date : 11/05/2013

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Directions to “ DIANGELIA BROWN ” Practice Location

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