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General NPI Number Information
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NPI Number | 1669922274
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Entity Type | Individual
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Provider Name | NICOLE BROWN BCBA
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Gender | Female
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Dates
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Enumeration Date | 10/06/2016
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Last Update Date | 02/04/2019
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Provider Practice Location Address
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Address Line | 10320 HICKORY RIDGE RD APT 824
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City | COLUMBIA
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State | MD
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Zip | 21044-4056
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Country | US
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Telephone | 304-312-9069
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Fax |
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Provider Business Mailing Address
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Address Line | 10320 HICKORY RIDGE RD APT. 824
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City | COLUMBIA
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State | MD
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Zip | 21044-4779
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Country | US
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Telephone | 304-312-9069
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 270
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License Number State | MD
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