Provider Demographics
NPI:1740381151
Name:BROWN, KENYA MICHELLE (MSR, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KENYA
Middle Name:MICHELLE
Last Name:BROWN
Suffix:
Gender:F
Credentials:MSR, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 NATCHEZ CT
Mailing Address - Street 2:
Mailing Address - City:GRAY COURT
Mailing Address - State:SC
Mailing Address - Zip Code:29645-4197
Mailing Address - Country:US
Mailing Address - Phone:864-876-0011
Mailing Address - Fax:
Practice Address - Street 1:301 PINEHAVEN STREET EXT
Practice Address - Street 2:
Practice Address - City:LAURENS
Practice Address - State:SC
Practice Address - Zip Code:29360-2671
Practice Address - Country:US
Practice Address - Phone:864-984-6584
Practice Address - Fax:864-984-6464
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3291235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist