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Individual

ROSENITA BROWN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
693 WATSON REEF, STONE MOUNTAIN, GA 30087-6117
(404) 313-9359
Mailing address
693 WATSON REEF, STONE MOUNTAIN, GA 30087-6117

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
00210596
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
282237019A
GA
Enumeration date
01/03/2008
Last updated
01/03/2008
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