Provider Demographics
NPI:1003118738
Name:BROWN, KIMBERLEE DAWN
Entity Type:Individual
Prefix:MS
First Name:KIMBERLEE
Middle Name:DAWN
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 1:601 VISTA LN TRLR 138
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-6370
Mailing Address - Country:US
Mailing Address - Phone:405-863-4545
Mailing Address - Fax:
Practice Address - Street 1:2416 W BROOKS ST APT 1
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-3924
Practice Address - Country:US
Practice Address - Phone:405-982-8056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-01
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health