Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | ||
Y | 101YP2500X | Professional Counselor | 77642 | TX |
N | 101YS0200X | School Counselor |
NPI | 1205305810 |
---|---|
Provider Name | Bobbie Anne Brown |
First Address | Fort Worth, TX 76107-5672 |
Second Address | Fort Worth, TX 76107-5672 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2018 |
Last Update Date | 07/06/2019 |