Provider Demographics
NPI:1013279090
Name:LOUIS-BROWN, JENNIFER ANN (MA, CAS)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ANN
Last Name:LOUIS-BROWN
Suffix:
Gender:F
Credentials:MA, CAS
Other - Prefix:MISS
Other - First Name:JENNIFER
Other - Middle Name:ANN
Other - Last Name:LOUIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CAS
Mailing Address - Street 1:39 CAMBRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-6145
Mailing Address - Country:US
Mailing Address - Phone:518-348-0389
Mailing Address - Fax:
Practice Address - Street 1:39 CAMBRIDGE AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-6145
Practice Address - Country:US
Practice Address - Phone:518-348-0389
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-14
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool