Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | MSW004270 | GA |
NPI | 1003086133 |
---|---|
Provider Name | Mrs. Laparisienne Moore-Brown |
First Address | Topeka, KS 66611-1779 |
Second Address | Decatur, GA 30033-4004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/03/2008 |
Last Update Date | 04/03/2008 |