Provider Demographics
NPI:1376247031
Name:BROWN, KIMBERLY JANELLE (CPSS,CPRM,CCHW)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:JANELLE
Last Name:BROWN
Suffix:
Gender:F
Credentials:CPSS,CPRM,CCHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2621 CHENE CT APT 421
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48207-4971
Mailing Address - Country:US
Mailing Address - Phone:313-704-1530
Mailing Address - Fax:
Practice Address - Street 1:6309 MACK AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48207-2302
Practice Address - Country:US
Practice Address - Phone:313-331-3435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-28
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist