Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TA0700X | Adult Development & Aging Psychologist |
NPI | 1881203834 |
---|---|
Provider Name | Teevia C Brown |
First Address | Flint, MI 48504-1795 |
Second Address | Flint, MI 48503-2445 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2020 |
Last Update Date | 27/07/2020 |