Provider Demographics
NPI:1689715005
Name:BROWN, PAULA JEAN (PC)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:JEAN
Last Name:BROWN
Suffix:
Gender:F
Credentials:PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 MONUMENT ROAD
Mailing Address - Street 2:BELMONT CENTER
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19131
Mailing Address - Country:US
Mailing Address - Phone:215-581-9142
Mailing Address - Fax:215-581-3827
Practice Address - Street 1:4200 MONUMENT ROAD
Practice Address - Street 2:BELMONT CENTER
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19131
Practice Address - Country:US
Practice Address - Phone:215-581-9142
Practice Address - Fax:215-581-3827
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC003672101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor