Provider Demographics
NPI:1336528801
Name:BROWN, KRISTIN JONES (MS)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:JONES
Last Name:BROWN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 SPRINGBERRY CT
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32124-3627
Mailing Address - Country:US
Mailing Address - Phone:386-453-0667
Mailing Address - Fax:
Practice Address - Street 1:152 SPRINGBERRY CT
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32124-3627
Practice Address - Country:US
Practice Address - Phone:386-453-0667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-29
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health