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General NPI Number Information
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NPI Number | 1437376241
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Entity Type | Individual
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Provider Name | THERESA MARIE BROWN M.A.
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Gender | Female
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Dates
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Enumeration Date | 04/20/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 114 FORREST AVE 104
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City | NARBERTH
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State | PA
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Zip | 19072-2218
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Country | US
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Telephone | 610-664-5858
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Fax |
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Provider Business Mailing Address
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Address Line | 232 N WYNNEWOOD AVE
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City | WYNNEWOOD
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State | PA
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Zip | 19096-1434
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Country | US
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Telephone | 610-649-1389
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PS004502-L
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License Number State | PA
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