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NPI Code Detail

MEDICARE: MRS. MELISSA BROWN M.A.

MEDICARE: MRS. MELISSA BROWN M.A.
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1619395852
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MELISSA BROWN M.A.
Provider Business Mailing Address
First Line : 1925 S PERIMETER RD STE 120
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33309-7123
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1925 S PERIMETER RD STE 120
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33309-7123
Country : US
Telephone Number : 954-958-0988
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2014
Last Update Date : 04/04/2014

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