Provider Demographics
NPI:1871845099
Name:BROWN, GERALYN JEANETTE
Entity Type:Individual
Prefix:
First Name:GERALYN
Middle Name:JEANETTE
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 1:133 HIGHLAND PARK DR
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30605-3577
Mailing Address - Country:US
Mailing Address - Phone:706-372-5339
Mailing Address - Fax:
Practice Address - Street 1:133 HIGHLAND PARK DR
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30605-3577
Practice Address - Country:US
Practice Address - Phone:706-372-5339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-11
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor