Provider Demographics
NPI:1851544688
Name:BROWN-NELSON, LOIS ANN (FAODP)
Entity Type:Individual
Prefix:MS
First Name:LOIS
Middle Name:ANN
Last Name:BROWN-NELSON
Suffix:
Gender:F
Credentials:FAODP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14460 MAYFIELD ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48205-4131
Mailing Address - Country:US
Mailing Address - Phone:313-526-3046
Mailing Address - Fax:
Practice Address - Street 1:14460 MAYFIELD ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48205-4131
Practice Address - Country:US
Practice Address - Phone:313-526-3046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-24
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children