Individual
KELLY BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
14102 SULLYFIELD CIR STE 350C, CHANTILLY, VA 20151-1672
(703) 291-9047
Mailing address
2987 DISTRICT AVE APT 524, FAIRFAX, VA 22031-1537
(404) 401-9250
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
2201001909
VA
231H00000X
Audiologist
AUD004261
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2201001909
VIRGINIA AUDIOLOGY LICENSE
VA
Enumeration date
02/24/2021
Last updated
04/05/2023
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