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General NPI Number Information
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NPI Number | 1114265220
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Entity Type | Individual
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Provider Name | ASHLEY RENEE BROWN MSW, LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/24/2013
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Last Update Date | 04/04/2013
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Provider Practice Location Address
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Address Line | 4460 N ILLINOIS ST
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City | SWANSEA
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State | IL
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Zip | 62226-1899
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Country | US
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Telephone | 618-581-9103
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Fax | 618-222-7305
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Provider Business Mailing Address
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Address Line | 895 MALIBU WAY
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City | EDWARDSVILLE
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State | IL
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Zip | 62025-5155
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Country | US
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Telephone | 618-581-9103
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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 | 149014435
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License Number State | IL
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