Provider Demographics
NPI:1972756914
Name:BROWN, BARBARA ANN (BA)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:ANN
Last Name:BROWN
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 64 BOX 5450
Mailing Address - Street 2:
Mailing Address - City:TUSKAHOMA
Mailing Address - State:OK
Mailing Address - Zip Code:74574-9634
Mailing Address - Country:US
Mailing Address - Phone:918-522-4220
Mailing Address - Fax:
Practice Address - Street 1:1101 E MONROE AVE
Practice Address - Street 2:
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-4815
Practice Address - Country:US
Practice Address - Phone:918-421-7800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-03
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK101YM0800XMedicaid