Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 10946 | FL |
NPI | 1053894881 |
---|---|
Provider Name | Lauren Zellmer Brown |
First Address | Brandon, FL 33511-8181 |
Second Address | Brookpark, OH 44142-2817 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2018 |
Last Update Date | 04/12/2020 |