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NPI 1487581567

NPI 1487581567 : TASHA BROWN : PEACHTREE CITY, GA

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General NPI Number Information
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    NPI Number           |    1487581567
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    Entity Type          |    Individual 
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    Provider Name        |    TASHA BROWN
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/05/2026
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    Last Update Date     |    05/05/2026
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Provider Practice Location Address
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    Address Line         |    277 GA-74 STE 107
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    City                 |    PEACHTREE CITY
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    State                |    GA
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    Zip                  |    30269
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    Country              |    US
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    Telephone            |    678-833-0058
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    733 MILLER RUN 
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    City                 |    ATLANTA
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    State                |    GA
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    Zip                  |    30349-1048
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    Country              |    US
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    Telephone            |    631-374-9990
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    106S00000X
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    Taxonomy Name        |    Behavior Technician
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    License Number       |    RBT-26-532669
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    License Number State |    GA
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