Individual
TAMESHA SHANETTE BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7117 E RENO AVE, MIDWEST CITY, OK 73110-4444
(405) 610-5242
Mailing address
PO BOX 96142, OKLAHOMA CITY, OK 73143-6142
(405) 706-5002
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134671951
—
OK
Enumeration date
09/29/2021
Last updated
09/29/2021
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