Individual
JASON DANIEL BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
P0212049
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5X630
BLUE SHIELD PROVIDER #
AR
Enumeration date
06/12/2006
Last updated
11/17/2015
Update your record
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