Provider Demographics
NPI:1013730803
Name:BROWN, KODIE RAE (BSW)
Entity type:Individual
Prefix:
First Name:KODIE
Middle Name:RAE
Last Name:BROWN
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1604
Mailing Address - Street 2:
Mailing Address - City:GRAYSON
Mailing Address - State:KY
Mailing Address - Zip Code:41143-5604
Mailing Address - Country:US
Mailing Address - Phone:606-548-3850
Mailing Address - Fax:
Practice Address - Street 1:7349 US 60 W
Practice Address - Street 2:KVC KENTUCKY
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41102
Practice Address - Country:US
Practice Address - Phone:606-548-3850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-01
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker