Individual
THERESA BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
665 W 4TH ST, WINSTON SALEM, NC 27101-2701
(336) 725-8389
Mailing address
665 W 4TH ST, WINSTON SALEM, NC 27101-2701
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
1731
NC
Other
Enumeration date
01/03/2011
Last updated
01/03/2011
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