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General NPI Number Information
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NPI Number | 1902416753
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Entity Type | Individual
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Provider Name | ROSE MARIE BROWN RPSGT, CSE
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Gender | Female
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Dates
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Enumeration Date | 08/06/2020
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Last Update Date | 08/06/2020
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Provider Practice Location Address
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Address Line | 3067 E COPPER POINT DR
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City | MERIDIAN
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State | ID
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Zip | 83642-1740
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Country | US
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Telephone | 208-287-1733
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Fax | 208-287-1734
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Provider Business Mailing Address
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Address Line | 3317 S COBBLE PL
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City | MERIDIAN
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State | ID
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Zip | 83642-7374
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Country | US
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Telephone |
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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 | 225500000X
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Taxonomy Name | Respiratory/Developmental/Rehabilitative Specialist/Technologist
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License Number | PSG-056
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License Number State | ID
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