Provider Demographics
NPI:1891119855
Name:BROWN, KATHY (BS)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5853 LAUREL OAK DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31907-5342
Mailing Address - Country:US
Mailing Address - Phone:706-464-1055
Mailing Address - Fax:
Practice Address - Street 1:5853 LAUREL OAK DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31907-5342
Practice Address - Country:US
Practice Address - Phone:706-464-1055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-11
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker