MEDICARE: VINCENT BROWN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1184915480
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VINCENT BROWN

Provider Business Mailing Address
First Line	:	3450 W CHEYENNE AVE
Second Line	:	500
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-8222
Country	:	US
Telephone Number	:	702-631-0230
Fax Number	:	702-631-0809

Provider Business Practice Location Address
First Line	:	3450 W CHEYENNE AVE
Second Line	:	500
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-8222
Country	:	US
Telephone Number	:	702-631-0230
Fax Number	:	702-631-0809

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/21/2011
Last Update Date	:	04/21/2011

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Directions to “ VINCENT BROWN ” Practice Location

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