MEDICARE: TINA ALISHIA 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
1	374J00000X	Doula	20808	PA

General Provider Information

NPI Number	:	1629963384
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TINA ALISHIA BROWN

Provider Business Mailing Address
First Line	:	5643 LITCHFIELD ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19143-4716
Country	:	US
Telephone Number	:	215-834-9207
Fax Number	:	215-834-9207

Provider Business Practice Location Address
First Line	:	7408 W CHESTER PIKE
Second Line	:
City	:	UPPER DARBY
State	:	PA
Zip	:	19082-2006
Country	:	US
Telephone Number	:	215-834-9207
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/11/2025
Last Update Date	:	07/26/2025

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Directions to “ TINA ALISHIA BROWN ” Practice Location

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