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NPI Code Detail

MEDICARE: ELIZABETH MARIE BROWN BCBA

MEDICARE: ELIZABETH MARIE BROWN BCBA
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
1103K00000XBehavior Analyst0133001535VA

General Provider Information

NPI Number : 1265075303
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH MARIE BROWN BCBA
Provider Business Mailing Address
First Line : 1138 2ND ST SW
Second Line :
City : ROANOKE
State : VA
Zip : 24016-4725
Country : US
Telephone Number : 540-404-1189
Fax Number : 540-904-0096
Provider Business Practice Location Address
First Line : 1138 2ND ST SW
Second Line :
City : ROANOKE
State : VA
Zip : 24016-4725
Country : US
Telephone Number : 540-404-1189
Fax Number : 540-904-0096
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/22/2019
Last Update Date : 04/02/2021

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