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General NPI Number Information
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NPI Number | 1336448893
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Entity Type | Organization
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Legal Business Name | DR. CARYN BROWN INC
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Dates
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Enumeration Date | 03/23/2011
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Last Update Date | 03/23/2011
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Provider Practice Location Address
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Address Line | 119 W 86TH AVE
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City | MERRILLVILLE
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State | IN
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Zip | 46410-7063
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Country | US
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Telephone | 219-756-8944
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Fax | 219-756-8945
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Provider Business Mailing Address
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Address Line | 119 W 86TH AVE
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City | MERRILLVILLE
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State | IN
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Zip | 46410-7063
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Country | US
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Telephone | 219-756-8944
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Fax | 219-756-8945
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Authorized Official
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Title or Position | PRETSIDEN
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Name | DR. CARYN BROWN
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Credential | PSYD
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Telephone | 219-756-8944
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 20041341A
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License Number State | IN
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