Provider Demographics
NPI:1861618605
Name:BRAZILE, DORCAS ANN (BSW)
Entity type:Individual
Prefix:MRS
First Name:DORCAS
Middle Name:ANN
Last Name:BRAZILE
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 SCOTTWOOD ST
Mailing Address - Street 2:
Mailing Address - City:WEST MEMPHIS
Mailing Address - State:AR
Mailing Address - Zip Code:72301-3318
Mailing Address - Country:US
Mailing Address - Phone:870-702-6660
Mailing Address - Fax:
Practice Address - Street 1:1500 SCOTTWOOD ST
Practice Address - Street 2:
Practice Address - City:WEST MEMPHIS
Practice Address - State:AR
Practice Address - Zip Code:72301-3318
Practice Address - Country:US
Practice Address - Phone:870-702-6660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker