Individual
MR. JEFFREY BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA LP
Contact information
Practice address
1405 LILAC DR N, STE 130, GOLDEN VALLEY, MN 55422-4536
(763) 566-0922
(763) 503-9491
Mailing address
1405 LILAC DRIVE N, STE 130, GOLDEN VALLEY, MN 55422-4536
(763) 566-0922
(763) 503-9194
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP 2069
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
663282300
—
MN
Enumeration date
12/06/2005
Last updated
11/12/2010
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