Provider Demographics
NPI:1689423618
Name:BROWN, DANIELLE SUZANNE
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:SUZANNE
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 1:713 W WILLOW POINT PL
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23602-9425
Mailing Address - Country:US
Mailing Address - Phone:757-597-1348
Mailing Address - Fax:
Practice Address - Street 1:640 INDEPENDENCE PKWY STE 400
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-5205
Practice Address - Country:US
Practice Address - Phone:757-267-9634
Practice Address - Fax:757-215-2975
Is Sole Proprietor?:No
Enumeration Date:2024-05-13
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician