Provider Demographics
NPI:1861473670
Name:BROWN, KATHLEEN S (PHD)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:S
Last Name:BROWN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98-707 IHO PL
Mailing Address - Street 2:#805
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-2524
Mailing Address - Country:US
Mailing Address - Phone:808-433-1323
Mailing Address - Fax:
Practice Address - Street 1:1 JARRETT WHITE RD
Practice Address - Street 2:MCHK-PH
Practice Address - City:TAMC
Practice Address - State:HI
Practice Address - Zip Code:96859-5001
Practice Address - Country:US
Practice Address - Phone:808-433-1323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY488103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service