Healthcare Provider Details

I. General information

NPI: 1982632600
Provider Name (Legal Business Name): STEVEN D. BROWN PH.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

96 S. MAIN #2
EPHRAIM UT
84627
US

IV. Provider business mailing address

135 WEST 300 NORTH
EPHRAIM UT
84627
US

V. Phone/Fax

Practice location:
  • Phone: 435-283-5559
  • Fax: 435-283-5559
Mailing address:
  • Phone: 435-283-5559
  • Fax: 435-283-5559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number276028-5201
License Number StateUT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: