Basic Information
| Provider Information | |||||||||
| NPI: | 1942747035 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BROWN | ||||||||
| FirstName: | MELINDA | ||||||||
| MiddleName: | BETH | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MSW, LSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 SEAGATE | ||||||||
| Address2: | |||||||||
| City: | TOLEDO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 436041558 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | |||||||||
| FaxNumber: | 4198247359 | ||||||||
| Practice Location | |||||||||
| Address1: | 730 N MACOMB ST STE 200 | ||||||||
| Address2: | |||||||||
| City: | MONROE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481622904 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7342401760 | ||||||||
| FaxNumber: | 7342401763 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/26/2017 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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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 | 1041C0700X | 6802087966 | MI | N | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041C0700X | S 1500598 | OH | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.