Provider Demographics
NPI:1467766881
Name:BROWN, AMBER (MA)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4030 TATES CREEK RD
Mailing Address - Street 2:#3936
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40517-3073
Mailing Address - Country:US
Mailing Address - Phone:304-633-2487
Mailing Address - Fax:
Practice Address - Street 1:4030 TATES CREEK RD
Practice Address - Street 2:#3936
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40517-3073
Practice Address - Country:US
Practice Address - Phone:304-633-2487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-27
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist