Provider Demographics
NPI:1023561388
Name:BROWN, REBECCA LYNN (BA, DP-C)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:LYNN
Last Name:BROWN
Suffix:
Gender:F
Credentials:BA, DP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3410 OLD LANSING RD
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48917-4392
Mailing Address - Country:US
Mailing Address - Phone:517-657-2980
Mailing Address - Fax:517-993-5982
Practice Address - Street 1:3410 OLD LANSING RD
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48917-4392
Practice Address - Country:US
Practice Address - Phone:517-657-2980
Practice Address - Fax:517-993-5982
Is Sole Proprietor?:No
Enumeration Date:2016-08-03
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)