Provider Demographics
NPI:1134365729
Name:BROWN, REGINALD CURTIS (MHPP)
Entity type:Individual
Prefix:
First Name:REGINALD
Middle Name:CURTIS
Last Name:BROWN
Suffix:
Gender:M
Credentials:MHPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 SOUTH JEFFERSON
Mailing Address - Street 2:
Mailing Address - City:EL DORADO
Mailing Address - State:AR
Mailing Address - Zip Code:71730
Mailing Address - Country:US
Mailing Address - Phone:870-904-2978
Mailing Address - Fax:
Practice Address - Street 1:217 S JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:EL DORADO
Practice Address - State:AR
Practice Address - Zip Code:71730-5948
Practice Address - Country:US
Practice Address - Phone:870-904-2978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-02
Last Update Date:2009-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARNONEOtherMENTAL HEALTH PARAPROFESSIONAL