Healthcare Provider Details

I. General information

NPI: 1558416941
Provider Name (Legal Business Name): PENNY SUE BROWNING M.A., Q.M.H.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 07/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 CAMPUS DR SUITE 210
ABINGDON VA
24210-2589
US

IV. Provider business mailing address

610 CAMPUS DR SUITE 210
ABINGDON VA
24210-2589
US

V. Phone/Fax

Practice location:
  • Phone: 276-525-1611
  • Fax: 276-525-1609
Mailing address:
  • Phone: 276-525-1611
  • Fax: 276-525-1609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number942
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: