Provider Demographics
NPI:1730509142
Name:BROWNING, KATHLEEN (MT)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:BROWNING
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1317 TILAPIA TRL
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32724-4719
Mailing Address - Country:US
Mailing Address - Phone:856-297-5771
Mailing Address - Fax:
Practice Address - Street 1:1317 TILAPIA TRL
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32724-4719
Practice Address - Country:US
Practice Address - Phone:856-297-5771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-24
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 72794225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist