Provider Demographics
NPI:1336755370
Name:BROWER, IMARI JACOYA (LCSWA)
Entity Type:Individual
Prefix:
First Name:IMARI
Middle Name:JACOYA
Last Name:BROWER
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:MS
Other - First Name:IMARI
Other - Middle Name:JACOYA
Other - Last Name:BROWER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:IMARI J BROWER
Mailing Address - Street 1:16 SUMMERTREE LN APT G
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-5635
Mailing Address - Country:US
Mailing Address - Phone:336-407-3041
Mailing Address - Fax:
Practice Address - Street 1:16 SUMMERTREE LN APT G
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-5635
Practice Address - Country:US
Practice Address - Phone:336-407-3041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-16
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0148211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical