Provider Demographics
NPI:1225054174
Name:BROWN, BRENDA LEANNE (MASTER OF SCIENCE)
Entity Type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:LEANNE
Last Name:BROWN
Suffix:
Gender:F
Credentials:MASTER OF SCIENCE
Other - Prefix:
Other - First Name:BRENDA
Other - Middle Name:LEANNE
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MASTER OF SCIENCE L
Mailing Address - Street 1:592 HIGHWAY 160
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN HILL
Mailing Address - State:AR
Mailing Address - Zip Code:71642-9232
Mailing Address - Country:US
Mailing Address - Phone:870-940-0222
Mailing Address - Fax:
Practice Address - Street 1:592 HIGHWAY 160
Practice Address - Street 2:
Practice Address - City:FOUNTAIN HILL
Practice Address - State:AR
Practice Address - Zip Code:71642-9232
Practice Address - Country:US
Practice Address - Phone:870-940-0222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR05-5E101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health