Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 042 | LA |
N | 104100000X | Social Worker | 4890 | LA |
Y | 1041C0700X | Clinical Social Worker | 4890 | LA |
NPI | 1013066372 |
---|---|
Provider Name | Stella E Brown |
First Address | Clinton, LA 70722-0395 |
Second Address | Port Allen, LA 70767 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2007 |
Last Update Date | 25/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2194542 | (05) | LA |