Provider Demographics
NPI:1649586298
Name:BROWN, NICOLE MARIE (PSYD)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:MARIE
Last Name:BROWN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 TERRY DR
Mailing Address - Street 2:THE ATRIUM - SUITE 7
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1838
Mailing Address - Country:US
Mailing Address - Phone:215-860-1144
Mailing Address - Fax:215-860-9333
Practice Address - Street 1:4 TERRY DR
Practice Address - Street 2:THE ATRIUM - SUITE 7
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1838
Practice Address - Country:US
Practice Address - Phone:215-860-1144
Practice Address - Fax:215-860-9333
Is Sole Proprietor?:No
Enumeration Date:2010-08-20
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS016845103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical