Provider Demographics
NPI:1215208475
Name:BROWN, ARIANA ROSE (LMT)
Entity Type:Individual
Prefix:MS
First Name:ARIANA
Middle Name:ROSE
Last Name:BROWN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 S KIHEI RD
Mailing Address - Street 2:STE 102A
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-8179
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1325 S KIHEI RD
Practice Address - Street 2:STE 102A
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-8179
Practice Address - Country:US
Practice Address - Phone:503-949-9777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-19
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI12437174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist