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General NPI Number Information
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NPI Number | 1811338338
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Entity Type | Individual
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Provider Name | LUCILLA HUSTAD BROWN LAC
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Gender | Female
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Dates
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Enumeration Date | 07/12/2013
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Last Update Date | 07/12/2013
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Provider Practice Location Address
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Address Line | 115 N. COOPER
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City | OLATHE
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State | KS
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Zip | 66061
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Country | US
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Telephone | 913-780-9600
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Fax | 913-273-0720
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Provider Business Mailing Address
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Address Line | 115 N COOPER ST
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City | OLATHE
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State | KS
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Zip | 66061-3434
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Country | US
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Telephone | 913-780-9600
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Fax | 913-273-0720
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 153
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License Number State | KS
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