Provider Demographics
NPI:1194253468
Name:BROWN, JAMIE LEIGH (MED)
Entity type:Individual
Prefix:MS
First Name:JAMIE
Middle Name:LEIGH
Last Name:BROWN
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1449 TEMPLE RD
Mailing Address - Street 2:
Mailing Address - City:BREMEN
Mailing Address - State:GA
Mailing Address - Zip Code:30110-2378
Mailing Address - Country:US
Mailing Address - Phone:770-537-2367
Mailing Address - Fax:770-537-1203
Practice Address - Street 1:1449 TEMPLE RD
Practice Address - Street 2:
Practice Address - City:BREMEN
Practice Address - State:GA
Practice Address - Zip Code:30110-2378
Practice Address - Country:US
Practice Address - Phone:770-537-2367
Practice Address - Fax:770-537-1203
Is Sole Proprietor?:No
Enumeration Date:2017-05-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
GALPC011468101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional