Healthcare Provider Details

I. General information

NPI: 1629308325
Provider Name (Legal Business Name): SANDRA R BROWN PHD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2010
Last Update Date: 01/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

191 E CHESTNUT ST
ASHEVILLE NC
28801-2330
US

IV. Provider business mailing address

191 E CHESTNUT ST
ASHEVILLE NC
28801-2330
US

V. Phone/Fax

Practice location:
  • Phone: 828-258-2112
  • Fax: 828-258-3831
Mailing address:
  • Phone: 828-258-2112
  • Fax: 828-258-3831

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number76
License Number StateNC

VIII. Authorized Official

Name: SANDRA R BROWN
Title or Position: OWNER
Credential: PHD
Phone: 828-258-2112