Individual
JERRY W BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
6300 RIVERSIDE PLAZA LN NW, SUITE 100, ALBUQUERQUE, NM 87120-2617
(505) 400-7282
Mailing address
PO BOX 94508, ALBUQUERQUE, NM 87199-4508
(505) 400-7282
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2389
NM
103TC0700X
Clinical Psychologist
2389
NM
Other
Enumeration date
02/06/2007
Last updated
05/11/2017
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