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Individual

CARISSA BROWN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4989 S WASHINGTON AVE, TITUSVILLE, FL 32780-7307
(321) 383-9606
Mailing address
1360 HILL AVE, MELBOURNE, FL 32940-6949
(321) 242-4838

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
9685
LICENSE #
FL
Enumeration date
08/20/2006
Last updated
07/08/2007
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