MEDICARE: CINTHIA GABRIELA BROWN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	0017196	CO

General Provider Information

NPI Number	:	1003456997
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CINTHIA GABRIELA BROWN

Provider Business Mailing Address
First Line	:	912 W JEFFERSON ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-6640
Country	:	US
Telephone Number	:	719-306-4824
Fax Number	:

Provider Business Practice Location Address
First Line	:	3055 AUSTIN BLUFFS PKWY STE C
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-5758
Country	:	US
Telephone Number	:	719-344-9428
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2020
Last Update Date	:	01/08/2020

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