Provider Demographics
NPI:1376701854
Name:BROWN, JAN RUTLEDGE (MSCCC/A)
Entity Type:Individual
Prefix:MRS
First Name:JAN
Middle Name:RUTLEDGE
Last Name:BROWN
Suffix:
Gender:F
Credentials:MSCCC/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7777 FOREST LN
Mailing Address - Street 2:C-506
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2505
Mailing Address - Country:US
Mailing Address - Phone:972-566-7515
Mailing Address - Fax:972-566-7067
Practice Address - Street 1:7777 FOREST LN
Practice Address - Street 2:C-506
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2505
Practice Address - Country:US
Practice Address - Phone:972-566-7515
Practice Address - Fax:972-566-7067
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-30
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50238231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist