Provider Demographics
NPI:1497145288
Name:BROWN, DONNA BETH (MM, MT-BC)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:BETH
Last Name:BROWN
Suffix:
Gender:F
Credentials:MM, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3314 STONY BROOK DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-1538
Mailing Address - Country:US
Mailing Address - Phone:502-376-9064
Mailing Address - Fax:
Practice Address - Street 1:3314 STONY BROOK DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40299-1538
Practice Address - Country:US
Practice Address - Phone:502-376-9064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-30
Last Update Date:2015-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
07250225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
07250OtherBOARD CERTIFICATION NUMBER, CERTIFICATION BOARD OF MUSIC THERAPISTS