Provider Demographics
NPI:1740281732
Name:BROWNMILLER, PATRICIA M (MA)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:M
Last Name:BROWNMILLER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 N CLAUDE A LORD BLVD
Mailing Address - Street 2:
Mailing Address - City:POTTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17901-2706
Mailing Address - Country:US
Mailing Address - Phone:570-622-1025
Mailing Address - Fax:570-628-4344
Practice Address - Street 1:450 N CLAUDE A LORD BLVD
Practice Address - Street 2:
Practice Address - City:POTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17901-2706
Practice Address - Country:US
Practice Address - Phone:570-622-1025
Practice Address - Fax:570-628-4344
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS008046L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA019034Medicare ID - Type Unspecified