Provider Demographics
NPI:1679343214
Name:BROWN, GAYSHA L
Entity Type:Individual
Prefix:
First Name:GAYSHA
Middle Name:L
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 NW 31ST AVE STE 2000
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33311-6653
Mailing Address - Country:US
Mailing Address - Phone:954-357-5005
Mailing Address - Fax:954-357-6533
Practice Address - Street 1:3275 NW 99TH WAY
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-4024
Practice Address - Country:US
Practice Address - Phone:954-357-5005
Practice Address - Fax:954-357-6533
Is Sole Proprietor?:No
Enumeration Date:2024-01-04
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)