Provider Demographics
NPI:1962376178
Name:BROWN, MIKAYLA RHEA
Entity type:Individual
Prefix:
First Name:MIKAYLA
Middle Name:RHEA
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MIKAYLA
Other - Middle Name:RHEA
Other - Last Name:WATSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4823 AVENUE Q 1/2
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77551-5266
Mailing Address - Country:US
Mailing Address - Phone:409-392-0788
Mailing Address - Fax:
Practice Address - Street 1:4823 AVENUE Q 1/2
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77551-5266
Practice Address - Country:US
Practice Address - Phone:409-392-0788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-01
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX92618101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor