Provider Demographics
NPI:1700494168
Name:BROWNING-VOLLMER, MARVETTE RENEE
Entity Type:Individual
Prefix:
First Name:MARVETTE
Middle Name:RENEE
Last Name:BROWNING-VOLLMER
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 1:1056 GREEN ACRES RD # 102-360
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97408-1505
Mailing Address - Country:US
Mailing Address - Phone:541-224-6987
Mailing Address - Fax:
Practice Address - Street 1:1056 GREEN ACRES RD # 102-360
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97408-1505
Practice Address - Country:US
Practice Address - Phone:541-224-6987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-21
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORABA-IN-10198239106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician