Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker |
NPI | 1003070806 |
---|---|
Provider Name | Mrs. Denise A.g. Brown-Walters |
First Address | Walden, NY 12586-1252 |
Second Address | Liberty, NY 12754-2851 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2008 |
Last Update Date | 11/07/2008 |