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NPI Code Detail

MEDICARE: DEBORAH L BROWNLEE LISW

MEDICARE: DEBORAH L BROWNLEE LISW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerI.1000233OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1SW37721OTHEROHMEDICARE PTAN

General Provider Information

NPI Number : 1255304911
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORAH L BROWNLEE LISW
Provider Business Mailing Address
First Line : 1522 E US HIGHWAY 36
Second Line : STE A
City : URBANA
State : OH
Zip : 43078-9738
Country : US
Telephone Number : 937-376-8700
Fax Number :
Provider Business Practice Location Address
First Line : 1521 N DETROIT ST
Second Line :
City : WEST LIBERTY
State : OH
Zip : 43357-0817
Country : US
Telephone Number : 937-465-8065
Fax Number : 937-465-3505
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2006
Last Update Date : 02/24/2021

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Directions to “ DEBORAH L BROWNLEE LISW” Practice Location

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