Provider Demographics
NPI:1801369905
Name:BROWN, TAMIKA RENE
Entity Type:Individual
Prefix:
First Name:TAMIKA
Middle Name:RENE
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 1:6913 BANKRUN TERRACE
Mailing Address - Street 2:
Mailing Address - City:DISTRICT HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20747
Mailing Address - Country:US
Mailing Address - Phone:240-462-8159
Mailing Address - Fax:
Practice Address - Street 1:9701 APOLLO DR STE 245
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-4787
Practice Address - Country:US
Practice Address - Phone:240-667-2404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-10
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health