Provider Demographics
NPI:1629859814
Name:BROWN, ARIELLE DOMINIQUE
Entity Type:Individual
Prefix:
First Name:ARIELLE
Middle Name:DOMINIQUE
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 1:5817 MARIGNY ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70122-5348
Mailing Address - Country:US
Mailing Address - Phone:337-277-5969
Mailing Address - Fax:
Practice Address - Street 1:2550 BELLE CHASSE HWY STE 220
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70053-6733
Practice Address - Country:US
Practice Address - Phone:504-367-6888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-12
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12190104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker