Provider Demographics
NPI:1881722403
Name:BROWN, BILLY WADE (MA)
Entity type:Individual
Prefix:MR
First Name:BILLY
Middle Name:WADE
Last Name:BROWN
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1002 BRINDLEY DR
Mailing Address - Street 2:
Mailing Address - City:PULASKI
Mailing Address - State:TN
Mailing Address - Zip Code:38478-4705
Mailing Address - Country:US
Mailing Address - Phone:931-363-5438
Mailing Address - Fax:
Practice Address - Street 1:1002 BRINDLEY DR
Practice Address - Street 2:
Practice Address - City:PULASKI
Practice Address - State:TN
Practice Address - Zip Code:38478-4705
Practice Address - Country:US
Practice Address - Phone:931-363-5438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional