Doctor Name: | MR. KEVIN G BROWN |
NPI Number: | 1013168970 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 81840 Avenue 46 201 Indio, CA - 922013936 |
Business Phone Number: | 7603916999 |
Business Fax Number: | 7603916998 |
Mailing Address: | 81840 Avenue 46, 201 INDIO |
State: | CA |
Postal Code: | 922013936 |
Phone Number: | 7603916999 |
Fax Number: | 7603916998 |
NPI Enumeration Date: | 10/08/2008 |
NPI Last Update Date: | 10/08/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |