Provider Demographics
NPI:1821893785
Name:BROWN, DEBORAH RAPHAELLA
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:RAPHAELLA
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 1:4058 CRAGGY PERCH
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-8709
Mailing Address - Country:US
Mailing Address - Phone:470-695-1109
Mailing Address - Fax:
Practice Address - Street 1:4058 CRAGGY PERCH
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-8709
Practice Address - Country:US
Practice Address - Phone:470-695-1109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-15
Last Update Date:2025-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician