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General NPI Number Information
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NPI Number | 1801923339
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Entity Type | Individual
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Provider Name | DR. BONNIE MARIE BROWN
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Gender | Female
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 1675 E MT GARFIELD RD STE 135
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City | MUSKEGON
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State | MI
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Zip | 49444-7732
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Country | US
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Telephone | 231-799-8880
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Fax | 231-799-8803
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Provider Business Mailing Address
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Address Line | 2780 S JONES BLVD SUITE 108
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City | LAS VEGAS
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State | NV
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Zip | 89146-5628
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Country | US
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Telephone | 888-320-2271
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Fax | 888-765-5221
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY0405
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | PY0405
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 6301017020
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 6301017020
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License Number State | MI
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