Provider Demographics
NPI:1699502245
Name:BROWN, VANESSA DANIELLE
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:DANIELLE
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 1:537 S SEQUOIA DR APT 107
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-3646
Mailing Address - Country:US
Mailing Address - Phone:561-537-6250
Mailing Address - Fax:
Practice Address - Street 1:1715 E TIFFANY DR
Practice Address - Street 2:
Practice Address - City:MANGONIA PARK
Practice Address - State:FL
Practice Address - Zip Code:33407-3277
Practice Address - Country:US
Practice Address - Phone:561-537-6250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-17
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW206161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical