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General NPI Number Information
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NPI Number | 1770938193
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Entity Type | Individual
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Provider Name | ANTRESIYA BROWN CSW
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Gender | Female
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Dates
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Enumeration Date | 05/04/2016
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 809 POLK ST
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City | MANSFIELD
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State | LA
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Zip | 71052-2452
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Country | US
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Telephone | 318-871-5566
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Fax | 318-871-1076
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Provider Business Mailing Address
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Address Line | 9112 CANDLESTICK LN
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City | SHREVEPORT
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State | LA
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Zip | 71118-2303
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Country | US
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Telephone | 318-773-3325
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 19380
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License Number State | LA
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