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General NPI Number Information
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NPI Number | 1689096034
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Entity Type | Individual
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Provider Name | GENA BROWN
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Gender | Female
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Dates
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Enumeration Date | 01/19/2014
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Last Update Date | 10/16/2023
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Provider Practice Location Address
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Address Line | 5210 W 26TH ST N
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City | MUSKOGEE
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State | OK
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Zip | 74401-5428
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Country | US
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Telephone | 918-706-0333
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Fax |
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Provider Business Mailing Address
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Address Line | 2420 N 24TH ST W
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City | MUSKOGEE
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State | OK
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Zip | 74401-2241
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Country | US
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Telephone | 918-706-0333
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 10636
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License Number State | OK
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