Doctor Name: | MR. SHELVY BROWN |
NPI Number: | 1033402797 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | BS |
License Number: | 260192 |
Business Practice Address: | 14305 Tawney Ridge Ln Victorville, CA - 923943222 |
Business Phone Number: | 7609610162 |
Business Fax Number: | 7609610162 |
Mailing Address: | 14305 Tawney Ridge Ln, VICTORVILLE |
State: | CA |
Postal Code: | 923943222 |
Phone Number: | 7609610162 |
Fax Number: | 7609610162 |
NPI Enumeration Date: | 05/26/2011 |
NPI Last Update Date: | 05/26/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225800000X |
License Number: | 260192 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Recreation Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | A recreation therapist uses recreational activities for intervention in some physical, social or emotional behavior to bring about a desired change in that behavior and promote the growth and development of the patient. |