Healthcare Provider Details

I. General information

NPI: 1255944286
Provider Name (Legal Business Name): HOLLI BROWN BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2020
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2329 E WT HARRIS BLVD
CHARLOTTE NC
28213-5186
US

IV. Provider business mailing address

301 RAILROAD ST
ROEBUCK SC
29376-3122
US

V. Phone/Fax

Practice location:
  • Phone: 704-529-9090
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-21-55431
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: