Healthcare Provider Details

I. General information

NPI: 1851700868
Provider Name (Legal Business Name): MICHELLE PFLEEGER BROWN MA/CAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MICHELLE PFLEEGER MA/CAS

II. Dates (important events)

Enumeration Date: 08/05/2014
Last Update Date: 08/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4425 RANDOLPH RD SUITE 411
CHARLOTTE NC
28211-2351
US

IV. Provider business mailing address

4425 RANDOLPH RD SUITE 411
CHARLOTTE NC
28211-2351
US

V. Phone/Fax

Practice location:
  • Phone: 704-362-5355
  • Fax: 704-362-1170
Mailing address:
  • Phone: 704-362-5355
  • Fax: 704-362-1170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number3430
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: