1770501363 NPI number — TAWANDA NAOMI TURNER-BROWN LICENSED SOCIAL WORK

Table of content: TAWANDA NAOMI TURNER-BROWN LICENSED SOCIAL WORK (NPI 1770501363)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770501363 NPI number — TAWANDA NAOMI TURNER-BROWN LICENSED SOCIAL WORK

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TURNER-BROWN
Provider First Name:
TAWANDA
Provider Middle Name:
NAOMI
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LICENSED SOCIAL WORK
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1770501363
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9501 FARRELL RD
Provider Second Line Business Mailing Address:
DEWITT ARMY COMMUNITY HOSPITAL
Provider Business Mailing Address City Name:
FORT BELVOIR
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22060-5901
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-805-0342
Provider Business Mailing Address Fax Number:
703-805-0731

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9501 FARRELL RD
Provider Second Line Business Practice Location Address:
DEWITT ARMY COMMUNITY HOSPITAL
Provider Business Practice Location Address City Name:
FORT BELVOIR
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22060-5901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-805-0342
Provider Business Practice Location Address Fax Number:
703-805-0731
Provider Enumeration Date:
07/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , with the licence number:  0904003142 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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