Healthcare Provider Details

I. General information

NPI: 1588184543
Provider Name (Legal Business Name): BRIENNE BENNETT BROWN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2017
Last Update Date: 06/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1777 S BELLAIRE ST STE 390
DENVER CO
80222-4306
US

IV. Provider business mailing address

15 POINTVIEW PL
MOUNTAIN LAKES NJ
07046-1643
US

V. Phone/Fax

Practice location:
  • Phone: 720-515-4244
  • Fax:
Mailing address:
  • Phone: 201-400-6639
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPSYC.00013827
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: