Healthcare Provider Details

I. General information

NPI: 1073641619
Provider Name (Legal Business Name): LANA LEIGH BROWN BSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1090 OLD FLORENCE RD
LAWRENCEBURG TN
38464-8401
US

IV. Provider business mailing address

2204 COUNTY ROAD 103
KILLEN AL
35645-5228
US

V. Phone/Fax

Practice location:
  • Phone: 931-762-6505
  • Fax:
Mailing address:
  • Phone: 256-272-8181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: