Provider Demographics
NPI:1679133219
Name:BROWN-TUYISHIMIRE, REBECCA DENISE
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:DENISE
Last Name:BROWN-TUYISHIMIRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:DENISE
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1170 SHAWNEE ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31419-1618
Mailing Address - Country:US
Mailing Address - Phone:912-920-0214
Mailing Address - Fax:
Practice Address - Street 1:SAVANNAH OUTPATIENT CLINIC
Practice Address - Street 2:1170 SHAWNEE STREET
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31419
Practice Address - Country:US
Practice Address - Phone:912-920-0214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-17
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health