Provider Demographics
NPI:1578669107
Name:DEBROWN, JANE H (PSYD)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:H
Last Name:DEBROWN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 S LAKESHORE DR STE 300
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-7028
Mailing Address - Country:US
Mailing Address - Phone:480-756-1669
Mailing Address - Fax:480-756-2132
Practice Address - Street 1:4500 S LAKESHORE DR STE 300
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7028
Practice Address - Country:US
Practice Address - Phone:480-756-1669
Practice Address - Fax:480-756-2132
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1820103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0613200OtherBC/BS
AZAZ0613200OtherBC/BS