Healthcare Provider Details

I. General information

NPI: 1528883519
Provider Name (Legal Business Name): ROSALYN BROWN MS, LCGC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2024
Last Update Date: 11/15/2024
Certification Date: 11/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CHILDRENS PLZ
DAYTON OH
45404-1815
US

IV. Provider business mailing address

1 CHILDRENS PLZ
DAYTON OH
45404-1815
US

V. Phone/Fax

Practice location:
  • Phone: 937-641-3800
  • Fax: 937-641-3617
Mailing address:
  • Phone: 937-641-3800
  • Fax: 937-641-3617

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number70.000866
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: