Provider Demographics
NPI:1770250235
Name:BROWN, TIFFANY (BSW)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:RENE
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSW
Mailing Address - Street 1:5900 TOWNSEND RD APT 1431
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32244-4585
Mailing Address - Country:US
Mailing Address - Phone:954-589-8063
Mailing Address - Fax:
Practice Address - Street 1:5900 TOWNSEND RD APT 1431
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32244-4585
Practice Address - Country:US
Practice Address - Phone:954-589-8063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health