Provider Demographics
NPI:1295980084
Name:BROWN, BRENDA E (MS, LMFT)
Entity type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:E
Last Name:BROWN
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1017 AZURE CIR
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67235-9438
Mailing Address - Country:US
Mailing Address - Phone:316-773-5320
Mailing Address - Fax:
Practice Address - Street 1:7200 W 13TH ST N
Practice Address - Street 2:SUITE #9
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212-2968
Practice Address - Country:US
Practice Address - Phone:316-721-8118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-20
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1019106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist