Provider Demographics
NPI:1184174971
Name:PRIGGE BROWN, AMBER LYN (MOTR/L)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:LYN
Last Name:PRIGGE BROWN
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:LYN
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MOTR/L
Mailing Address - Street 1:2200 LIBRARY CIR
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-6326
Mailing Address - Country:US
Mailing Address - Phone:701-757-2155
Mailing Address - Fax:
Practice Address - Street 1:2200 LIBRARY CIR
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-6326
Practice Address - Country:US
Practice Address - Phone:701-757-2155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-05
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1517225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist