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NPI Code Detail

MEDICARE: MIKAELA K BROWN

MEDICARE:   MIKAELA K 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
1106S00000XBehavior TechnicianRBT-25-441533TX

General Provider Information

NPI Number : 1295688398
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIKAELA K BROWN
Provider Business Mailing Address
First Line : 10217 LAKE TAHOE CT
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-6916
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5750 FALLS DR
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-7147
Country : US
Telephone Number : 260-702-9898
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/18/2026
Last Update Date : 02/18/2026

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Directions to “ MIKAELA K BROWN ” Practice Location

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