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NPI Code Detail

MEDICARE: JOBEANNA BROWN

MEDICARE:   JOBEANNA  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 Technician

General Provider Information

NPI Number : 1366251753
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOBEANNA BROWN
Provider Business Mailing Address
First Line : 5655 S MICHIGAN AVE APT 1F
Second Line :
City : CHICAGO
State : IL
Zip : 60637-1124
Country : US
Telephone Number : 573-318-1115
Fax Number :
Provider Business Practice Location Address
First Line : 5655 S MICHIGAN AVE
Second Line : APT 1F
City : CHICAGO
State : IL
Zip : 60637-1124
Country : US
Telephone Number : 573-318-1115
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/31/2024
Last Update Date : 12/31/2024

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Directions to “ JOBEANNA BROWN ” Practice Location

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