Provider Demographics
NPI:1235464157
Name:BROWN, VIRGINIA (MA)
Entity Type:Individual
Prefix:MS
First Name:VIRGINIA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6827 MAGNOLIA POINTE CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32810-3537
Mailing Address - Country:US
Mailing Address - Phone:407-294-1035
Mailing Address - Fax:
Practice Address - Street 1:6827 MAGNOLIA POINTE CIR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32810-3537
Practice Address - Country:US
Practice Address - Phone:407-294-1035
Practice Address - Fax:407-294-1035
Is Sole Proprietor?:No
Enumeration Date:2009-10-09
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health