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NPI Code Detail

MEDICARE: JESSIE BROWN

MEDICARE: JESSIE BROWN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior AnalystBH03168PA

General Provider Information

NPI Number : 1023568623
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSIE BROWN
Provider Business Mailing Address
First Line : 542 AMHERST ST STE B
Second Line :
City : NASHUA
State : NH
Zip : 03063-1016
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 999 OLD EAGLE RD STE 120
Second Line :
City : WAYNE
State : PA
Zip : 19087-1707
Country : US
Telephone Number : 561-867-4944
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2016
Last Update Date : 01/14/2026

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