Provider Demographics
NPI:1003122243
Name:BROWN, PATRICIA ANN (MA CCC/SLP)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:ANN
Last Name:BROWN
Suffix:
Gender:F
Credentials:MA CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3176 DOME ROCK PL
Mailing Address - Street 2:UNIT 14B
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301-6602
Mailing Address - Country:US
Mailing Address - Phone:406-498-0003
Mailing Address - Fax:928-441-1695
Practice Address - Street 1:3176 DOME ROCK PL
Practice Address - Street 2:UNIT 14B
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-6602
Practice Address - Country:US
Practice Address - Phone:406-498-0003
Practice Address - Fax:928-441-1695
Is Sole Proprietor?:No
Enumeration Date:2010-08-25
Last Update Date:2016-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9852235Z00000X
MT1078235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist