Provider Demographics
NPI:1154904167
Name:BROWN, TAMIKO Y (MA)
Entity type:Individual
Prefix:
First Name:TAMIKO
Middle Name:Y
Last Name:BROWN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16333 COLUMNS WAY APT 10205
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70817-7752
Mailing Address - Country:US
Mailing Address - Phone:225-220-0750
Mailing Address - Fax:
Practice Address - Street 1:16333 COLUMNS WAY APT 10205
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70817-7752
Practice Address - Country:US
Practice Address - Phone:225-220-0750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-29
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8938101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health