Provider Demographics
NPI:1295093524
Name:BROWN, NATALIE ANN (NATALIE BROWN)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:ANN
Last Name:BROWN
Suffix:
Gender:F
Credentials:NATALIE BROWN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24742 PORTSMOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48374-3133
Mailing Address - Country:US
Mailing Address - Phone:248-349-0771
Mailing Address - Fax:
Practice Address - Street 1:43455 W 10 MILE RD
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-3100
Practice Address - Country:US
Practice Address - Phone:248-349-2200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-24
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201005777225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist