Healthcare Provider Details

I. General information

NPI: 1811915937
Provider Name (Legal Business Name): JOYCE A. BROWN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 S BRONSON ST
WARSAW IN
46580-3519
US

IV. Provider business mailing address

223 S BRONSON ST
WARSAW IN
46580-3519
US

V. Phone/Fax

Practice location:
  • Phone: 574-268-1164
  • Fax: 574-268-1176
Mailing address:
  • Phone: 574-268-1164
  • Fax: 574-268-1176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34000854A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: