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NPI Code Detail

MEDICARE: CASSANDRA BROWN LDN

MEDICARE: CASSANDRA BROWN LDN
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
1133V00000XRegistered DietitianDT85896TX

General Provider Information

NPI Number : 1740846781
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASSANDRA BROWN LDN
Provider Business Mailing Address
First Line : 175 E HAWTHORN PKWY STE 235
Second Line :
City : VERNON HILLS
State : IL
Zip : 60061-1454
Country : US
Telephone Number : 847-737-8768
Fax Number : 847-859-5885
Provider Business Practice Location Address
First Line : 422 E LAMAR BLVD STE 108
Second Line :
City : ARLINGTON
State : TX
Zip : 76011-3604
Country : US
Telephone Number : 817-751-7802
Fax Number : 847-859-5885
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2019
Last Update Date : 05/15/2019

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Directions to “ CASSANDRA BROWN LDN” Practice Location

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