Healthcare Provider Details

I. General information

NPI: 1043792161
Provider Name (Legal Business Name): VANESSA BROWN PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2018
Last Update Date: 01/23/2022
Certification Date: 01/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3811 OHARA ST
PITTSBURGH PA
15213-2561
US

IV. Provider business mailing address

7116 HARRISON AVE
PITTSBURGH PA
15218-2024
US

V. Phone/Fax

Practice location:
  • Phone: 412-624-1000
  • Fax:
Mailing address:
  • Phone: 515-401-8713
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS019161
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: