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General NPI Number Information
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NPI Number | 1194083550
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Entity Type | Individual
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Provider Name | TIFFANY BROOK BROWN PH.D.
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Gender | Female
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Dates
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Enumeration Date | 04/23/2012
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Last Update Date | 04/23/2012
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Provider Practice Location Address
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Address Line | 492 W BROADWAY
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City | EUGENE
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State | OR
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Zip | 97401-2834
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Country | US
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Telephone | 541-521-0178
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Fax |
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Provider Business Mailing Address
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Address Line | 5251 UNIVERSITY OF OREGON
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City | EUGENE
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State | OR
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Zip | 97403-5295
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Country | US
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Telephone | 541-521-0178
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | TO791
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License Number State | OR
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