Provider Demographics
NPI:1376232140
Name:BROWN, OUIDA (CHHC, CN)
Entity Type:Individual
Prefix:MRS
First Name:OUIDA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:CHHC, CN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7452 PORTBURY PARK LN
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-6662
Mailing Address - Country:US
Mailing Address - Phone:404-242-8329
Mailing Address - Fax:404-242-8329
Practice Address - Street 1:7452 PORTBURY PARK LN
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-6662
Practice Address - Country:US
Practice Address - Phone:404-242-8329
Practice Address - Fax:404-242-8329
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GANA171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach