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General NPI Number Information
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NPI Number | 1003482639
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Entity Type | Individual
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Provider Name | CHRISTA DEVAUGHN BROWN LICSW
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Gender | Female
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Dates
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Enumeration Date | 06/03/2021
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Last Update Date | 06/09/2021
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Provider Practice Location Address
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Address Line | 3220 5TH AVE S STE 100
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City | BIRMINGHAM
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State | AL
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Zip | 35222-2309
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Country | US
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Telephone | 205-877-8677
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Fax | 205-877-8675
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Provider Business Mailing Address
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Address Line | 894 77TH WAY S
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City | BIRMINGHAM
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State | AL
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Zip | 35206-4905
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Country | US
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Telephone | 205-305-8659
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 4763C
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License Number State | AL
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