MEDICARE: AARON JERRELL 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	:	1225523558
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AARON JERRELL BROWN

Provider Business Mailing Address
First Line	:	52 RIDGEWAY RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45216-1002
Country	:	US
Telephone Number	:	513-503-4120
Fax Number	:

Provider Business Practice Location Address
First Line	:	52 RIDGEWAY RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45216-1002
Country	:	US
Telephone Number	:	513-503-4120
Fax Number	:

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

Provider Enumeration Date	:	06/28/2018
Last Update Date	:	06/28/2018

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