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NPI Code Detail

MEDICARE: STEPHANIE BROWN

MEDICARE: STEPHANIE 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
1103K00000XBehavior Analyst12580747MN

General Provider Information

NPI Number : 1346911880
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE BROWN
Provider Business Mailing Address
First Line : 4141 SUNSHINE DR
Second Line :
City : OAK GROVE
State : MN
Zip : 55303-8985
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3401 ROUND LAKE BLVD NW
Second Line :
City : ANOKA
State : MN
Zip : 55303-3315
Country : US
Telephone Number : 612-509-7113
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2021
Last Update Date : 04/23/2025

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Directions to “ STEPHANIE BROWN ” Practice Location

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