Provider Demographics
NPI:1689824500
Name:BROWN, WARNELLA C (MSCCCSLP)
Entity Type:Individual
Prefix:MS
First Name:WARNELLA
Middle Name:C
Last Name:BROWN
Suffix:
Gender:F
Credentials:MSCCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 230103
Mailing Address - Street 2:P.O. BOX 230103
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-0103
Mailing Address - Country:US
Mailing Address - Phone:347-524-4780
Mailing Address - Fax:
Practice Address - Street 1:2795 SHORE PARKWAY
Practice Address - Street 2:APT. 4J
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223
Practice Address - Country:US
Practice Address - Phone:718-891-0427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-28
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006685-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist