Provider Demographics
NPI:1578798682
Name:BROWN, JODI HARA (MD)
Entity Type:Individual
Prefix:DR
First Name:JODI
Middle Name:HARA
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JODI
Other - Middle Name:HARA
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:909 OAK RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-1733
Mailing Address - Country:US
Mailing Address - Phone:610-527-0955
Mailing Address - Fax:
Practice Address - Street 1:909 OAK RIDGE RD
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-1733
Practice Address - Country:US
Practice Address - Phone:610-527-0955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-18
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD049452L2084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry