Provider Demographics
NPI:1114695780
Name:BROWN, NATALIE MORGAN (RBT)
Entity Type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:MORGAN
Last Name:BROWN
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:MISS
Other - First Name:NATALIE
Other - Middle Name:MORGAN
Other - Last Name:KELLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1720 BASSETT DR
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-6569
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:800-513-7805
Practice Address - Street 1:219 42ND ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97478-5937
Practice Address - Country:US
Practice Address - Phone:541-224-7967
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-31
Last Update Date:2023-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
GABACB710090106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician