Provider Demographics
NPI:1073741443
Name:BROWN, TERESA A (MSW)
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:A
Last Name:BROWN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2774 STANFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32814-6774
Mailing Address - Country:US
Mailing Address - Phone:407-221-5332
Mailing Address - Fax:
Practice Address - Street 1:2774 STANFIELD AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32814-6774
Practice Address - Country:US
Practice Address - Phone:407-221-5332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-24
Last Update Date:2009-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL758776700Medicaid