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General NPI Number Information
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NPI Number | 1699449165
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Entity Type | Individual
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Provider Name | ENRIQUE SIMON BROWN
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Gender | Male
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Dates
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Enumeration Date | 08/06/2021
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Last Update Date | 08/06/2021
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Provider Practice Location Address
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Address Line | 35 SUMMER ST STE 104
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City | TAUNTON
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State | MA
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Zip | 02780-3469
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Country | US
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Telephone | 508-397-8857
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Fax | 508-824-2120
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Provider Business Mailing Address
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Address Line | 75 LOWELL AVE APT #1
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City | PROVIDENCE
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State | RI
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Zip | 02909
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Country | US
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Telephone | 786-277-4792
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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