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General NPI Number Information
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NPI Number | 1447984810
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Entity Type | Individual
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Provider Name | CRYSTAL RANE BROWN LAC
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Gender | Female
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Dates
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Enumeration Date | 07/12/2022
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Last Update Date | 02/07/2026
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Provider Practice Location Address
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Address Line | 21259 E OCOTILLO RD
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-9339
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Country | US
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Telephone | 480-582-4604
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Fax |
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Provider Business Mailing Address
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Address Line | 1347 N ALMA SCHOOL RD STE 200
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City | CHANDLER
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State | AZ
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Zip | 85224-5932
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Country | US
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Telephone | 480-582-2871
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | AZ
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