Provider Demographics
NPI:1649323759
Name:BROWN, MARY FRANCES
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:FRANCES
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:FRANCES
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW, CSW
Mailing Address - Street 1:21630 W MCNICHOLS RD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48219-3209
Mailing Address - Country:US
Mailing Address - Phone:313-543-9311
Mailing Address - Fax:313-543-0003
Practice Address - Street 1:21630 W MCNICHOLS RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48219-3209
Practice Address - Country:US
Practice Address - Phone:313-543-9311
Practice Address - Fax:313-543-0003
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010708081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical