Provider Demographics
NPI:1649617853
Name:BROWN, ROBINIQUE LASHAY
Entity type:Individual
Prefix:MISS
First Name:ROBINIQUE
Middle Name:LASHAY
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3930 ACCENT DR
Mailing Address - Street 2:APT# 2624
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-7713
Mailing Address - Country:US
Mailing Address - Phone:214-995-1040
Mailing Address - Fax:
Practice Address - Street 1:3930 ACCENT DR
Practice Address - Street 2:APT# 2624
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287-7713
Practice Address - Country:US
Practice Address - Phone:214-995-1040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-29
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200447620AMedicaid