Provider Demographics
NPI:1639234735
Name:BROWN, CLAIRE E (PHD)
Entity Type:Individual
Prefix:DR
First Name:CLAIRE
Middle Name:E
Last Name:BROWN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:125 RIDGEWAY DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-3404
Mailing Address - Country:US
Mailing Address - Phone:337-984-9186
Mailing Address - Fax:337-984-9185
Practice Address - Street 1:125 RIDGEWAY DR
Practice Address - Street 2:SUITE B
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-3404
Practice Address - Country:US
Practice Address - Phone:337-984-9186
Practice Address - Fax:337-984-9185
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA861103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAR81865Medicare UPIN
LA4C009Medicare ID - Type UnspecifiedMEDICARE