Healthcare Provider Details

I. General information

NPI: 1962470088
Provider Name (Legal Business Name): FELICIA FAYE BROWN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 01/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 NW 76TH DR
GAINESVILLE FL
32607-6668
US

IV. Provider business mailing address

250 NW 76TH DR
GAINESVILLE FL
32607-6668
US

V. Phone/Fax

Practice location:
  • Phone: 352-505-6363
  • Fax: 866-215-3205
Mailing address:
  • Phone: 352-505-6363
  • Fax: 866-215-3205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number979
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number7698
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number979
License Number StateNH
# 4
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number7698
License Number StateMA
# 5
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY9288
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: