Provider Demographics
NPI:1538478789
Name:BROWNE, MYLA (PHD)
Entity Type:Individual
Prefix:
First Name:MYLA
Middle Name:
Last Name:BROWNE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2744 LAUREL ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68502-5142
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:LINCOLN REGIONAL CENTER BUILDING 3
Practice Address - Street 2:W. PROSPECTOR PLACE AND FOLSOM ST.
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68509-4949
Practice Address - Country:US
Practice Address - Phone:402-479-5202
Practice Address - Fax:402-479-5238
Is Sole Proprietor?:No
Enumeration Date:2010-10-05
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE669103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical