Basic Information
| Provider Information | |||||||||
| NPI: | 1801135140 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BROWN | ||||||||
| FirstName: | PAULA | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | CT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 137 STETZER RD | ||||||||
| Address2: | |||||||||
| City: | BUCYRUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 448202076 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4195621740 | ||||||||
| FaxNumber: | 4195626880 | ||||||||
| Practice Location | |||||||||
| Address1: | 137 STETZER RD | ||||||||
| Address2: | |||||||||
| City: | BUCYRUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 448202076 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4195621740 | ||||||||
| FaxNumber: | 4195626880 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/06/2013 | ||||||||
| LastUpdateDate: | 03/29/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | E1200.231 | OH | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.