Provider Demographics
NPI:1447402979
Name:BROWN, REBA SECUNDA (MSW)
Entity Type:Individual
Prefix:
First Name:REBA
Middle Name:SECUNDA
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 1:1700 HAMPSHIRE DRIVE
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28146
Mailing Address - Country:US
Mailing Address - Phone:704-630-6634
Mailing Address - Fax:
Practice Address - Street 1:1720 HAMPSHIRE DR
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28146-7211
Practice Address - Country:US
Practice Address - Phone:704-630-6634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-15
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health