Provider Demographics
NPI:1972299535
Name:BROWN, TIMESHA CHRISTINA AZARIA
Entity Type:Individual
Prefix:
First Name:TIMESHA
Middle Name:CHRISTINA AZARIA
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 1:1404 RIVERSTONE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-6711
Mailing Address - Country:US
Mailing Address - Phone:931-626-5941
Mailing Address - Fax:
Practice Address - Street 1:1404 RIVERSTONE DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-6711
Practice Address - Country:US
Practice Address - Phone:931-626-5941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-17
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker