Healthcare Provider Details
I. General information
NPI: 1932794914
Provider Name (Legal Business Name): DILLON MICHAEL BROWN BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/02/2021
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6805 ALPINE CURRANT VW APT 203
COLORADO SPRINGS CO
80918-9038
US
IV. Provider business mailing address
1418 E 71ST ST STE B
TULSA OK
74136-5059
US
V. Phone/Fax
- Phone: 918-359-9550
- Fax:
- Phone: 918-359-9550
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | 1-25-81426 |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: