Provider Demographics
NPI:1295207207
Name:BROWNE, SANDRA RAYE (LPC)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:RAYE
Last Name:BROWNE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1213 SIGNAL RIDGE PL
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-5400
Mailing Address - Country:US
Mailing Address - Phone:575-937-6872
Mailing Address - Fax:469-264-5037
Practice Address - Street 1:1101 RIDGE RD STE 237
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-4250
Practice Address - Country:US
Practice Address - Phone:575-937-6872
Practice Address - Fax:469-264-5037
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-02
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12299101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional