Doctor Name: | MISS JESSI EDEN BROWN |
NPI Number: | 1811216195 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, LMHC, LPC, NCC |
License Number: | LPC-4029 |
Business Practice Address: | 4714 Ne 178th St Lake Forest Park, WA - 981554533 |
Business Phone Number: | 2538866153 |
Business Fax Number: | |
Mailing Address: | 4714 Ne 178th St, LAKE FOREST PARK |
State: | WA |
Postal Code: | 981554533 |
Phone Number: | 2538866153 |
Fax Number: | |
NPI Enumeration Date: | 05/25/2010 |
NPI Last Update Date: | 04/12/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | LPC-4029 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |