Healthcare Provider Details

I. General information

NPI: 1770731440
Provider Name (Legal Business Name): JOANN BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2008
Last Update Date: 09/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 COMER AVE
COLUMBUS GA
31904-8725
US

IV. Provider business mailing address

4814 ATTERBURY DR
COLUMBUS GA
31907-5065
US

V. Phone/Fax

Practice location:
  • Phone: 706-596-5583
  • Fax: 706-596-5589
Mailing address:
  • Phone: 706-987-4787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: