Provider Demographics
NPI:1801135140
Name:BROWN, PAULA L (CT)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:L
Last Name:BROWN
Suffix:
Gender:F
Credentials:CT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 STETZER RD
Mailing Address - Street 2:
Mailing Address - City:BUCYRUS
Mailing Address - State:OH
Mailing Address - Zip Code:44820-2076
Mailing Address - Country:US
Mailing Address - Phone:419-562-1740
Mailing Address - Fax:419-562-6880
Practice Address - Street 1:137 STETZER RD
Practice Address - Street 2:
Practice Address - City:BUCYRUS
Practice Address - State:OH
Practice Address - Zip Code:44820-2076
Practice Address - Country:US
Practice Address - Phone:419-562-1740
Practice Address - Fax:419-562-6880
Is Sole Proprietor?:No
Enumeration Date:2013-02-06
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE1200.231101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional