Healthcare Provider Details

I. General information

NPI: 1902752496
Provider Name (Legal Business Name): DELANEY THOMPSON-BROWN
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2026
Last Update Date: 03/06/2026
Certification Date: 03/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 E MELBOURNE AVE STE D
MELBOURNE FL
32901-5976
US

IV. Provider business mailing address

13 E MELBOURNE AVE STE D
MELBOURNE FL
32901-5976
US

V. Phone/Fax

Practice location:
  • Phone: 321-888-3438
  • Fax: 321-225-6772
Mailing address:
  • Phone: 321-888-3438
  • Fax: 321-225-6772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: