Provider Demographics
NPI:1255676797
Name:BROWN, BEVERLY J
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:J
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1004 HICKORY HILL LN STE 2
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-1931
Mailing Address - Country:US
Mailing Address - Phone:615-902-0950
Mailing Address - Fax:
Practice Address - Street 1:1004 HICKORY HILL LN STE 2
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-1931
Practice Address - Country:US
Practice Address - Phone:615-902-0950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-11
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst