Provider Demographics
NPI:1598506255
Name:BROWN, PORCHA DENECKA
Entity type:Individual
Prefix:
First Name:PORCHA
Middle Name:DENECKA
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 1:8711 W CONGRESS ST APT 3
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53225-5059
Mailing Address - Country:US
Mailing Address - Phone:262-838-1518
Mailing Address - Fax:
Practice Address - Street 1:8711 W CONGRESS ST APT 3
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53225-5059
Practice Address - Country:US
Practice Address - Phone:262-838-1518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician