Basic Information
| Provider Information | |||||||||
| NPI: | 1518405026 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BROWN | ||||||||
| FirstName: | TONYA | ||||||||
| MiddleName: | YVETTE | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LGSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1900 N HOWARD ST | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212185909 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4434290529 | ||||||||
| FaxNumber: | 4437735624 | ||||||||
| Practice Location | |||||||||
| Address1: | 1900 N HOWARD ST | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212185909 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4434290529 | ||||||||
| FaxNumber: | 4437735624 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/03/2017 | ||||||||
| LastUpdateDate: | 02/03/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 19673 | MD | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.