Provider Demographics
NPI:1063876332
Name:BROWN, MARIE FRANCES
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:FRANCES
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:283 ADAMS ST
Mailing Address - Street 2:APT 1R
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07105-1562
Mailing Address - Country:US
Mailing Address - Phone:201-317-2794
Mailing Address - Fax:973-732-6970
Practice Address - Street 1:283 ADAMS ST
Practice Address - Street 2:APT 1R
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07105-1562
Practice Address - Country:US
Practice Address - Phone:201-317-2794
Practice Address - Fax:973-732-6970
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-12
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00436200101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health