Provider Demographics
NPI:1871794693
Name:BROWN, STEPHANIE ANTOINETTE (LSW)
Entity type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:ANTOINETTE
Last Name:BROWN
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:283 SOUTHWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43207-1267
Mailing Address - Country:US
Mailing Address - Phone:614-443-6242
Mailing Address - Fax:614-445-9709
Practice Address - Street 1:283 SOUTHWOOD AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43207-1267
Practice Address - Country:US
Practice Address - Phone:614-443-6242
Practice Address - Fax:614-445-9709
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist