Provider Demographics
NPI:1386436707
Name:BROWN, HALLE MATULA
Entity type:Individual
Prefix:
First Name:HALLE
Middle Name:MATULA
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4828 ASHFORD DUNWOODY RD STE 100
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30338-4833
Mailing Address - Country:US
Mailing Address - Phone:770-238-2674
Mailing Address - Fax:
Practice Address - Street 1:4828 ASHFORD DUNWOODY RD STE 100
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30338-4833
Practice Address - Country:US
Practice Address - Phone:770-238-2674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-21
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty