Healthcare Provider Details

I. General information

NPI: 1275882797
Provider Name (Legal Business Name): DAWN MARIE BROWN LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2012
Last Update Date: 09/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 CORNELL RD
YPSILANTI MI
48197-1657
US

IV. Provider business mailing address

1055 CORNELL RD
YPSILANTI MI
48197-1657
US

V. Phone/Fax

Practice location:
  • Phone: 734-487-2890
  • Fax: 734-485-2892
Mailing address:
  • Phone: 734-487-2890
  • Fax: 734-485-2892

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801062866
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: