Individual
KHADIJAH REGINE BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(678) 209-2394
Mailing address
1567 HARVARD AVE APT 1, COLLEGE PARK, GA 30337-2960
(470) 399-2064
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
MSW009592
GA
Other
Enumeration date
12/18/2020
Last updated
12/18/2020
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