Individual
ANNA NICOLE BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSW
Contact information
Practice address
2025 JEBS CT NW, KENNESAW, GA 30144-2881
(706) 853-5149
Mailing address
2025 JEBS CT NW, KENNESAW, GA 30144-2881
(706) 853-5149
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000000
SUBSTANCE ABUSE
GA
05
—
000000000
—
GA
Enumeration date
09/15/2022
Last updated
09/15/2022
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