Provider Demographics
NPI:1568804243
Name:BROWN, MICHELLE ANNMARIE (NO CREDENTIALS)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:ANNMARIE
Last Name:BROWN
Suffix:
Gender:F
Credentials:NO CREDENTIALS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16101 89TH AVE
Mailing Address - Street 2:JAMAICA
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-3902
Mailing Address - Country:US
Mailing Address - Phone:718-262-8190
Mailing Address - Fax:
Practice Address - Street 1:16101 89TH AVE
Practice Address - Street 2:JAMAICA
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-3902
Practice Address - Country:US
Practice Address - Phone:718-262-8190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-23
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health