Provider Demographics
NPI:1811144116
Name:BROWN, MERRIN J (MOT, OTL)
Entity type:Individual
Prefix:MRS
First Name:MERRIN
Middle Name:J
Last Name:BROWN
Suffix:
Gender:F
Credentials:MOT, OTL
Other - Prefix:MISS
Other - First Name:MERRIN
Other - Middle Name:J
Other - Last Name:WARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:4785 S. EDINBERGH DRIVE
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701
Mailing Address - Country:US
Mailing Address - Phone:865-617-5257
Mailing Address - Fax:
Practice Address - Street 1:2137 16TH ST
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:IN
Practice Address - Zip Code:47421-3003
Practice Address - Country:US
Practice Address - Phone:812-275-5593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-19
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH007012225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist