Individual
DR. CHARLES JACOB BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D
Contact information
Practice address
726 EAST BLVD, CHARLOTTE, NC 28203-5114
(704) 376-8494
Mailing address
726 EAST BLVD, CHARLOTTE, NC 28203-5114
(704) 376-8494
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PP1981
NC
174400000X
Specialist
Primary
1981
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
123456
NOT APPLICABLE
MD
Enumeration date
07/28/2006
Last updated
10/25/2022
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