Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
N | 101YP1600X | Pastoral Counselor |
NPI | 1073164190 |
---|---|
Provider Name | Dana Lee Brown |
First Address | Seneca, SC 29678-3827 |
Second Address | Seneca, SC 29678 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2019 |
Last Update Date | 20/09/2019 |