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NPI Code Detail

MEDICARE: BOBBIE ANNE BROWN MED, LPC

MEDICARE:   BOBBIE ANNE  BROWN  MED, LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YS0200XSchool Counselor
2101YP2500XProfessional Counselor77642TX
3101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1205305810
Entity Type Code : Individual
Provider Name (Legal Business Name) : BOBBIE ANNE BROWN MED, LPC
Provider Business Mailing Address
First Line : 3901 W VICKERY BLVD STE 1
Second Line :
City : FORT WORTH
State : TX
Zip : 76107-5672
Country : US
Telephone Number : 817-609-6733
Fax Number :
Provider Business Practice Location Address
First Line : 3901 W VICKERY BLVD STE 1
Second Line :
City : FORT WORTH
State : TX
Zip : 76107-5672
Country : US
Telephone Number : 817-609-6733
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2018
Last Update Date : 06/07/2019

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Directions to “ BOBBIE ANNE BROWN MED, LPC” Practice Location

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