Provider Demographics
NPI:1467065870
Name:BROWNSON, MIATTA
Entity Type:Individual
Prefix:
First Name:MIATTA
Middle Name:
Last Name:BROWNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:522 OTTO AVE
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08010-2012
Mailing Address - Country:US
Mailing Address - Phone:609-433-2795
Mailing Address - Fax:
Practice Address - Street 1:522 OTTO AVE
Practice Address - Street 2:
Practice Address - City:EDGEWATER PARK
Practice Address - State:NJ
Practice Address - Zip Code:08010-2012
Practice Address - Country:US
Practice Address - Phone:609-433-2795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-25
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor