Healthcare Provider Details

I. General information

NPI: 1306750807
Provider Name (Legal Business Name): MRS. AMBER BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4005 E 11 MILE RD
WARREN MI
48092-3000
US

IV. Provider business mailing address

31806 PAM CT
FRASER MI
48026-2601
US

V. Phone/Fax

Practice location:
  • Phone: 586-804-2018
  • Fax:
Mailing address:
  • Phone: 313-574-7594
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6851122574
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: