Provider Demographics
NPI:1881143394
Name:BROWN, KATLYN (AT)
Entity type:Individual
Prefix:
First Name:KATLYN
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:AT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 SANDERS AVE
Mailing Address - Street 2:
Mailing Address - City:SCOTIA
Mailing Address - State:NY
Mailing Address - Zip Code:12302-2107
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8461 OH-144
Practice Address - Street 2:FEDERAL HOCKING HIGH SCHOOL
Practice Address - City:STEWART
Practice Address - State:OH
Practice Address - Zip Code:45778
Practice Address - Country:US
Practice Address - Phone:740-593-1217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-26
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT0048822255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer