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General NPI Number Information
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NPI Number | 1750870911
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Entity Type | Organization
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Legal Business Name | S. WYN BROWN, LLC
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Dates
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Enumeration Date | 05/03/2018
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Last Update Date | 03/18/2021
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Provider Practice Location Address
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Address Line | 45 DARBY RD STE F
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City | PAOLI
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State | PA
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Zip | 19301-1475
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Country | US
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Telephone | 267-640-6682
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Fax |
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Provider Business Mailing Address
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Address Line | 45 DARBY RD STE F
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City | PAOLI
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State | PA
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Zip | 19301-1475
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Country | US
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Telephone | 267-640-6682
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | WYN BROWN
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Credential | MA, LPC
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Telephone | 267-640-6682
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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 | PC005601
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License Number State | PA
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