Provider Demographics
NPI:1124826631
Name:BROWN, AYANA C
Entity type:Individual
Prefix:
First Name:AYANA
Middle Name:C
Last Name:BROWN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2450 WILSON RD NW
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30012-2722
Mailing Address - Country:US
Mailing Address - Phone:678-697-8782
Mailing Address - Fax:
Practice Address - Street 1:2450 WILSON RD NW
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30012-2722
Practice Address - Country:US
Practice Address - Phone:770-906-8815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician