Provider Demographics
NPI:1366581514
Name:BROWN, KARYN D
Entity type:Individual
Prefix:
First Name:KARYN
Middle Name:D
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9750 N MONTEREY DR
Mailing Address - Street 2:UNIT # 47
Mailing Address - City:FOUNTAIN HILLS
Mailing Address - State:AZ
Mailing Address - Zip Code:85268-6738
Mailing Address - Country:US
Mailing Address - Phone:480-836-1795
Mailing Address - Fax:
Practice Address - Street 1:16000 E PALISADES BLVD
Practice Address - Street 2:
Practice Address - City:FOUNTAIN HILLS
Practice Address - State:AZ
Practice Address - Zip Code:85268-3131
Practice Address - Country:US
Practice Address - Phone:480-664-5018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool