Provider Demographics
NPI:1255602603
Name:BROWN, HEATHER KRISTEEN (BHRS)
Entity type:Individual
Prefix:MISS
First Name:HEATHER
Middle Name:KRISTEEN
Last Name:BROWN
Suffix:
Gender:F
Credentials:BHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18736 S 585 RD
Mailing Address - Street 2:
Mailing Address - City:STILWELL
Mailing Address - State:OK
Mailing Address - Zip Code:74960-2706
Mailing Address - Country:US
Mailing Address - Phone:918-931-9646
Mailing Address - Fax:
Practice Address - Street 1:18736 S 585 RD
Practice Address - Street 2:
Practice Address - City:STILWELL
Practice Address - State:OK
Practice Address - Zip Code:74960-2706
Practice Address - Country:US
Practice Address - Phone:918-931-9646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-17
Last Update Date:2012-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool