1346356706 NPI number — MS. ALICIA DOLORES BROWN MA,LPC

Table of content: MS. ALICIA DOLORES BROWN MA,LPC (NPI 1346356706)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346356706 NPI number — MS. ALICIA DOLORES BROWN MA,LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BROWN
Provider First Name:
ALICIA
Provider Middle Name:
DOLORES
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MA,LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346356706
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3570 DAVID K DR
Provider Second Line Business Mailing Address:
#108
Provider Business Mailing Address City Name:
WATERFORD
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48329-1315
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-623-7232
Provider Business Mailing Address Fax Number:
248-623-1134

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3570 DAVID K DR
Provider Second Line Business Practice Location Address:
#108
Provider Business Practice Location Address City Name:
WATERFORD
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48329-1315
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-623-7232
Provider Business Practice Location Address Fax Number:
248-623-1134
Provider Enumeration Date:
08/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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