Provider Demographics
NPI:1851700868
Name:BROWN, MICHELLE PFLEEGER (MA/CAS)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:PFLEEGER
Last Name:BROWN
Suffix:
Gender:F
Credentials:MA/CAS
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:PFLEEGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA/CAS
Mailing Address - Street 1:4425 RANDOLPH RD
Mailing Address - Street 2:SUITE 411
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-2351
Mailing Address - Country:US
Mailing Address - Phone:704-362-5355
Mailing Address - Fax:704-362-1170
Practice Address - Street 1:4425 RANDOLPH RD
Practice Address - Street 2:SUITE 411
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-2351
Practice Address - Country:US
Practice Address - Phone:704-362-5355
Practice Address - Fax:704-362-1170
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-05
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3430103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool