Healthcare Provider Details

I. General information

NPI: 1215725684
Provider Name (Legal Business Name): FREDERICK BROWNE PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2025
Last Update Date: 04/28/2025
Certification Date: 04/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5635 PINE KNOLL BLVD
NOBLESVILLE IN
46062-8414
US

IV. Provider business mailing address

5635 PINE KNOLL BLVD
NOBLESVILLE IN
46062-8414
US

V. Phone/Fax

Practice location:
  • Phone: 513-614-4915
  • Fax:
Mailing address:
  • Phone: 513-614-4915
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number6166
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: