Healthcare Provider Details

I. General information

NPI: 1629186366
Provider Name (Legal Business Name): HARVEY BROWN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

735 S ANN ST
BALTIMORE MD
21231-3402
US

IV. Provider business mailing address

960 FELL ST UNIT 507
BALTIMORE MD
21231-3556
US

V. Phone/Fax

Practice location:
  • Phone: 410-522-1181
  • Fax: 410-522-1182
Mailing address:
  • Phone: 410-522-1181
  • Fax: 410-522-1182

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number01672
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: