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NPI Code Detail

MEDICARE: TIFFANY BROWN

MEDICARE: TIFFANY BROWN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor0701008371

General Provider Information

NPI Number : 1003476839
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIFFANY BROWN
Provider Business Mailing Address
First Line : 1000 JEFFERSON ST STE 2C
Second Line :
City : LYNCHBURG
State : VA
Zip : 24504-1724
Country : US
Telephone Number : 757-657-8088
Fax Number : 617-807-0958
Provider Business Practice Location Address
First Line : 8 SAN JOSE DR STE 3E
Second Line :
City : NEWPORT NEWS
State : VA
Zip : 23606-3508
Country : US
Telephone Number : 757-657-8088
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2019
Last Update Date : 06/14/2019

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Directions to “ TIFFANY BROWN ” Practice Location

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