Provider Demographics
NPI:1699386425
Name:BROWN, MADELINE SUSAN (RD)
Entity type:Individual
Prefix:MRS
First Name:MADELINE
Middle Name:SUSAN
Last Name:BROWN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6341 ROCKLEDGE DR
Mailing Address - Street 2:
Mailing Address - City:BRECKSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44141-1745
Mailing Address - Country:US
Mailing Address - Phone:440-630-0544
Mailing Address - Fax:
Practice Address - Street 1:6341 ROCKLEDGE DR
Practice Address - Street 2:
Practice Address - City:BRECKSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44141-1745
Practice Address - Country:US
Practice Address - Phone:440-630-0544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-14
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD.7973133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered