Provider Demographics
NPI:1528357555
Name:BROWN, LORI LYN (PHD)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:LYN
Last Name:BROWN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:LYN
Other - Last Name:BROWN-FRANKEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6230 NW BARRY RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64154-2530
Mailing Address - Country:US
Mailing Address - Phone:816-505-3311
Mailing Address - Fax:816-505-3511
Practice Address - Street 1:3135 BOEING AVE STE A2
Practice Address - Street 2:
Practice Address - City:MCKINLEYVILLE
Practice Address - State:CA
Practice Address - Zip Code:95519-9373
Practice Address - Country:US
Practice Address - Phone:707-630-5093
Practice Address - Fax:707-630-5093
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-30
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2428103TC0700X
CA24201103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical