Provider Demographics
NPI:1558639393
Name:WILSON-BROWN, DEBORAH MARIE (CMT)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:MARIE
Last Name:WILSON-BROWN
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9067 FOOTHILLS BLVD.
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678
Mailing Address - Country:US
Mailing Address - Phone:916-367-7730
Mailing Address - Fax:
Practice Address - Street 1:9067 FOOTHILLS BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95747-5118
Practice Address - Country:US
Practice Address - Phone:916-367-7730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-08
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24877174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist