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Individual

TONYA BROWN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
12912 W MCLELLAN RD, GLENDALE, AZ 85307-1917
(313) 629-6680
Mailing address
PO BOX 16906, PHOENIX, AZ 85011-6906
(602) 279-1427
(602) 279-1431

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
8022998
AZ
385HR2055X
Child Mental Illness Respite Care
Primary
8022998
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8022998
AZ DEPT OF HEALTH SERVICES
AZ
Enumeration date
11/10/2016
Last updated
12/28/2020
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