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Individual

TIA BROWN BONDS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
BSW, MBA

Contact information

Practice address
12524 MERLIN AVE, BATON ROUGE, LA 70816
(225) 205-1820
Mailing address
12524 MERLIN AVE, BATON ROUGE, LA 70816-2494
(225) 205-1820

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
251B00000X
Case Management Agency
251S00000X
Community/Behavioral Health Agency
Primary
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
376J00000X
Homemaker

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1404942
LA
01
171M00000X
TAXONOMY
LA
05
46-3857583
LA
Enumeration date
07/12/2017
Last updated
08/01/2024
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