Provider Demographics
NPI:1427415710
Name:BROWN, LUCILLE (MT-BC)
Entity Type:Individual
Prefix:
First Name:LUCILLE
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8600 TYLER BLVD
Mailing Address - Street 2:#651
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-4352
Mailing Address - Country:US
Mailing Address - Phone:440-290-9883
Mailing Address - Fax:
Practice Address - Street 1:8600 TYLER BLVD
Practice Address - Street 2:#651
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-4352
Practice Address - Country:US
Practice Address - Phone:440-290-9883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-18
Last Update Date:2016-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist