Provider Demographics
NPI:1487499976
Name:BROWNE, AVA ALEETA
Entity type:Individual
Prefix:
First Name:AVA
Middle Name:ALEETA
Last Name:BROWNE
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 1:11309 BISHOPS GATE LN
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20723-2052
Mailing Address - Country:US
Mailing Address - Phone:240-463-0811
Mailing Address - Fax:
Practice Address - Street 1:4000 BLACKBURN LN STE 150
Practice Address - Street 2:
Practice Address - City:BURTONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20866-6127
Practice Address - Country:US
Practice Address - Phone:301-421-4241
Practice Address - Fax:410-696-3696
Is Sole Proprietor?:No
Enumeration Date:2024-06-27
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP15125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional