Provider Demographics
NPI:1538857818
Name:BROWN, KAITLIN (BA)
Entity type:Individual
Prefix:
First Name:KAITLIN
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 BEAR RUN
Mailing Address - Street 2:
Mailing Address - City:PIQUA
Mailing Address - State:OH
Mailing Address - Zip Code:45356-5417
Mailing Address - Country:US
Mailing Address - Phone:937-214-4737
Mailing Address - Fax:
Practice Address - Street 1:604 BEAR RUN
Practice Address - Street 2:
Practice Address - City:PIQUA
Practice Address - State:OH
Practice Address - Zip Code:45356-5417
Practice Address - Country:US
Practice Address - Phone:937-214-4737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health