Provider Demographics
NPI:1619519824
Name:BROWN, VICKI LYNNE
Entity Type:Individual
Prefix:
First Name:VICKI
Middle Name:LYNNE
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 E WYOMISSING BLVD
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19611-1748
Mailing Address - Country:US
Mailing Address - Phone:484-274-9161
Mailing Address - Fax:
Practice Address - Street 1:1202 E WYOMISSING BLVD
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19611-1748
Practice Address - Country:US
Practice Address - Phone:484-274-9161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-09
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASOLLENBERGER-001OtherVICKI SOLLENBERGER