Provider Demographics
NPI:1952528416
Name:BROWN, MARCELLA F (PERSONAL NEEDS ASSIS)
Entity Type:Individual
Prefix:MRS
First Name:MARCELLA
Middle Name:F
Last Name:BROWN
Suffix:
Gender:F
Credentials:PERSONAL NEEDS ASSIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1714 DOVER AVENUE
Mailing Address - Street 2:
Mailing Address - City:PIQUA
Mailing Address - State:OH
Mailing Address - Zip Code:45356-2724
Mailing Address - Country:US
Mailing Address - Phone:937-520-1900
Mailing Address - Fax:937-973-7914
Practice Address - Street 1:30 EAST BROAD STREET
Practice Address - Street 2:OHIO DEPT OF JOB & FAMILY SERVICES 33RD FLOOR BUREAU OF
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-3414
Practice Address - Country:US
Practice Address - Phone:614-466-6742
Practice Address - Fax:614-466-6945
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2206553Medicaid