Healthcare Provider Details

I. General information

NPI: 1285007435
Provider Name (Legal Business Name): TONYA BROWN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2015
Last Update Date: 11/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 VIRGINIA ST
PARIS TN
38242-5341
US

IV. Provider business mailing address

408 VIRGINIA ST PO BOX 30
PARIS TN
38242-5341
US

V. Phone/Fax

Practice location:
  • Phone: 731-644-1753
  • Fax: 731-642-1010
Mailing address:
  • Phone: 731-644-1753
  • Fax: 731-642-1010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLSW6132
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: