Provider Demographics
NPI:1780157677
Name:DANIELS-BROWN, ROMAN
Entity type:Individual
Prefix:
First Name:ROMAN
Middle Name:
Last Name:DANIELS-BROWN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9598 SUPERIOR CT NE
Mailing Address - Street 2:
Mailing Address - City:MOSES LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98837-8553
Mailing Address - Country:US
Mailing Address - Phone:509-989-7895
Mailing Address - Fax:
Practice Address - Street 1:7015 W DESCHUTES AVE STE B
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-7843
Practice Address - Country:US
Practice Address - Phone:509-572-2126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-03
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor