Doctor Name: | TEDDY BROWN |
NPI Number: | 1164629622 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 2007005866 |
Business Practice Address: | 118 W Spring St Neosho, MO - 648501720 |
Business Phone Number: | 4174516106 |
Business Fax Number: | |
Mailing Address: | 201 Verbryck St, CARL JUNCTION |
State: | MO |
Postal Code: | 648349742 |
Phone Number: | 4177821772 |
Fax Number: | 4177823832 |
NPI Enumeration Date: | 06/28/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 2007005866 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |