Provider Demographics
NPI:1871891846
Name:BROWNELL, MIKE D (MME, MT-BC)
Entity type:Individual
Prefix:MR
First Name:MIKE
Middle Name:D
Last Name:BROWNELL
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Gender:M
Credentials:MME, MT-BC
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Mailing Address - Street 1:1900 W STADIUM BLVD
Mailing Address - Street 2:SUITE E
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-7008
Mailing Address - Country:US
Mailing Address - Phone:734-395-4765
Mailing Address - Fax:772-673-8347
Practice Address - Street 1:1900 W STADIUM BLVD
Practice Address - Street 2:SUITE E
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-7008
Practice Address - Country:US
Practice Address - Phone:734-395-4765
Practice Address - Fax:772-673-8347
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-01
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
05855225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist