Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | CDCA.169981 | OH |
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | CDCA.173075 | OH |
NPI | 1003457193 |
---|---|
Provider Name | Alexandria Cortney Brown |
First Address | West Carrollton, OH 45449-1462 |
Second Address | Dayton, OH 45417-3445 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2019 |
Last Update Date | 11/03/2020 |