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NPI Code Detail

MEDICARE: RIAN BROWN-BEASLEY

MEDICARE:   RIAN  BROWN-BEASLEY
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 AnalystBH001112PA

General Provider Information

NPI Number : 1992102446
Entity Type Code : Individual
Provider Name (Legal Business Name) : RIAN BROWN-BEASLEY
Provider Business Mailing Address
First Line : 1021 GARFIELD AVE
Second Line :
City : GLENSIDE
State : PA
Zip : 19038-1910
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1021 GARFIELD AVE
Second Line :
City : GLENSIDE
State : PA
Zip : 19038-1910
Country : US
Telephone Number : 856-266-6390
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2014
Last Update Date : 11/28/2014

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Directions to “ RIAN BROWN-BEASLEY ” Practice Location

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