Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 104100000X | Social Worker | S.0500693 | OH |
N | 1041C0700X | Clinical Social Worker | S.0500693 | OH |
NPI | 1003051913 |
---|---|
Provider Name | Fawnette Brown |
First Address | Dayton, OH 45406-5965 |
Second Address | Dayton, OH 45406 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2008 |
Last Update Date | 02/12/2020 |