Provider Demographics
NPI:1902923881
Name:BROWN, SANDRA A (LSW, LMFT)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:A
Last Name:BROWN
Suffix:
Gender:F
Credentials:LSW, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1209 SOVEREIGN ROW
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73108-1824
Mailing Address - Country:US
Mailing Address - Phone:405-942-5570
Mailing Address - Fax:405-942-5603
Practice Address - Street 1:1209 SOVEREIGN ROW
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73108-1824
Practice Address - Country:US
Practice Address - Phone:405-942-5570
Practice Address - Fax:405-942-5603
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1660104100000X
OK649106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist