Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | ||
Y | 103T00000X | Psychologist | ||
N | 103TH0004X | Health Psychologist | ||
N | 103TH0100X | Health Service |
NPI | 1306227111 |
---|---|
Provider Name | Tawanda Unique Brown |
First Address | Harrisburg, PA 17104-1351 |
Second Address | Harrisburg, PA 17104-1351 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2015 |
Last Update Date | 17/06/2015 |