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General NPI Number Information
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NPI Number | 1538328604
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Entity Type | Individual
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Provider Name | BRENDA D. BROWN M.A., LPC
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Gender | Female
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Dates
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Enumeration Date | 06/04/2008
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Last Update Date | 09/09/2008
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Provider Practice Location Address
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Address Line | 3109 FALL CREEK HWY STE 5
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City | GRANBURY
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State | TX
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Zip | 76049-7929
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Country | US
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Telephone | 817-964-0107
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6607
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City | GRANBURY
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State | TX
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Zip | 76049-0118
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Country | US
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Telephone | 817-964-0107
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 62411
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License Number State | TX
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