Provider Demographics
NPI:1306227111
Name:BROWN, TAWANDA UNIQUE (MA)
Entity Type:Individual
Prefix:
First Name:TAWANDA
Middle Name:UNIQUE
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 1:1809 ZARKER ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17104-1351
Mailing Address - Country:US
Mailing Address - Phone:717-480-7381
Mailing Address - Fax:
Practice Address - Street 1:1809 ZARKER ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17104-1351
Practice Address - Country:US
Practice Address - Phone:717-480-7381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-17
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
No171W00000XOther Service ProvidersContractor
No172V00000XOther Service ProvidersCommunity Health Worker