Individual
JACKIE BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
305 FORK RD, FOUNTAIN, SC 29644-9477
(678) 463-2467
Mailing address
305 FORK RD, FOUNTAIN INN, SC 29644-9477
(678) 463-2467
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
02/02/2016
Last updated
02/02/2016
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