Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 2311G | AL |
NPI | 1003067653 |
---|---|
Provider Name | Mrs. Brooke M Brown |
First Address | Montevallo, AL 35115-5925 |
Second Address | Columbiana, AL 35051 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2008 |
Last Update Date | 01/10/2008 |