Provider Demographics
NPI:1316596067
Name:BROWN, JAMIE LEE
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:LEE
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:PO BOX 111
Mailing Address - Street 2:
Mailing Address - City:SHARPTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21861-0111
Mailing Address - Country:US
Mailing Address - Phone:443-359-0756
Mailing Address - Fax:
Practice Address - Street 1:505 CHURCH ST
Practice Address - Street 2:
Practice Address - City:SHARPTOWN
Practice Address - State:MD
Practice Address - Zip Code:21861-1017
Practice Address - Country:US
Practice Address - Phone:443-359-0756
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-05
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician