Provider Demographics
NPI:1821503954
Name:BROWNE, ALDRIC DEMOND
Entity Type:Individual
Prefix:
First Name:ALDRIC
Middle Name:DEMOND
Last Name:BROWNE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 AUGUSTINE RD
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29910-9527
Mailing Address - Country:US
Mailing Address - Phone:184-331-8332
Mailing Address - Fax:
Practice Address - Street 1:151 DILLION RD
Practice Address - Street 2:
Practice Address - City:HILTON HEAD
Practice Address - State:SC
Practice Address - Zip Code:29925
Practice Address - Country:US
Practice Address - Phone:843-318-1332
Practice Address - Fax:843-689-6267
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-12
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC222204Medicaid