Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 12-09P | AR |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 12-09P | AR |
N | 103G00000X | Clinical Psychologist | 12-09P | AR |
N | 103TC0700X | Clinical Psychologist | 12-09P | AR |
N | 103TH0004X | Health Psychologist | 12-09P | AR |
N | 103TP2701X | Group Psychotherapist | 12-09P | AR |
NPI | 1528319266 |
---|---|
Provider Name | Dr. Pamela Cheryl Brown |
First Address | Orlando, FL 32806-1873 |
Second Address | Orlando, FL 32803-8208 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2012 |
Last Update Date | 18/05/2019 |