Provider Demographics
NPI:1124246236
Name:BROWN, KATHLEEN D (MT-BC)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:D
Last Name:BROWN
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 LAKEVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKY RIVER
Mailing Address - State:OH
Mailing Address - Zip Code:44116-2409
Mailing Address - Country:US
Mailing Address - Phone:216-374-5558
Mailing Address - Fax:
Practice Address - Street 1:1620 LAKEVIEW AVE
Practice Address - Street 2:
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-2409
Practice Address - Country:US
Practice Address - Phone:216-374-5558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist