Healthcare Provider Details

I. General information

NPI: 1932892528
Provider Name (Legal Business Name): ILEENA BROWN MS.P
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2023
Last Update Date: 05/30/2023
Certification Date: 05/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2288 SECOND STREET PIKE STE 1
NEWTOWN PA
18940-4108
US

IV. Provider business mailing address

3701 CONCORD RD APT D6
ASTON PA
19014-1216
US

V. Phone/Fax

Practice location:
  • Phone: 215-772-0101
  • Fax:
Mailing address:
  • Phone: 267-251-1284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: