Provider Demographics
NPI:1811240088
Name:BROWN, TONJA (MSSW, LAPSW)
Entity Type:Individual
Prefix:MRS
First Name:TONJA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:MSSW, LAPSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1165 BREEZY VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-6668
Mailing Address - Country:US
Mailing Address - Phone:901-428-9989
Mailing Address - Fax:
Practice Address - Street 1:1165 BREEZY VALLEY DR
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-6668
Practice Address - Country:US
Practice Address - Phone:901-428-9989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-24
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
TNASW0000000192104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health