Healthcare Provider Details

I. General information

NPI: 1073438339
Provider Name (Legal Business Name): JASMIN BROWN M.A. E.DS.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 RIVERVIEW DR
BELMONT WV
26134-9715
US

IV. Provider business mailing address

4246 BUFFALO CREEK RD
SALEM WV
26426-8136
US

V. Phone/Fax

Practice location:
  • Phone: 304-684-2195
  • Fax:
Mailing address:
  • Phone: 304-672-6733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberJ8A150200250
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: