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General NPI Number Information
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NPI Number | 1366119406
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Entity Type | Organization
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Legal Business Name | MARSHA D BROWN PHD P A
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Dates
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Enumeration Date | 08/26/2021
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Last Update Date | 08/26/2021
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Provider Practice Location Address
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Address Line | 757 SE 17TH ST # 622
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City | FORT LAUDERDALE
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State | FL
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Zip | 33316-2960
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Country | US
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Telephone | 917-979-3743
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Fax | 954-743-0265
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Provider Business Mailing Address
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Address Line | 757 SE 17TH ST # 622
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City | FORT LAUDERDALE
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State | FL
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Zip | 33316-2960
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Country | US
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Telephone | 917-979-3743
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Fax | 954-743-0265
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Authorized Official
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Title or Position | OWNER
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Name | MARSHA D BROWN
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Credential | PH.D.
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Telephone | 917-979-3743
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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