Provider Demographics
NPI:1477907194
Name:BROWN, CHARLINE E
Entity Type:Individual
Prefix:
First Name:CHARLINE
Middle Name:E
Last Name:BROWN
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 1:235 S WATER ST
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25401-4241
Mailing Address - Country:US
Mailing Address - Phone:304-263-8954
Mailing Address - Fax:304-264-0763
Practice Address - Street 1:235 S WATER ST
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401-4241
Practice Address - Country:US
Practice Address - Phone:304-263-8954
Practice Address - Fax:304-264-0763
Is Sole Proprietor?:No
Enumeration Date:2016-04-19
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker