Provider Demographics
NPI:1376212159
Name:BROWN, KATELYN DENISE (PHD)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:DENISE
Last Name:BROWN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 ROSERY RD NE APT 2152
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33770-3848
Mailing Address - Country:US
Mailing Address - Phone:678-764-6836
Mailing Address - Fax:
Practice Address - Street 1:3310 CROASDAILE DR STE 400
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-6806
Practice Address - Country:US
Practice Address - Phone:919-384-9682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-07
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6682103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist