Provider Demographics
NPI:1487860854
Name:BROWN, JUDY ANNE
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:ANNE
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JUDY
Other - Middle Name:ANNE
Other - Last Name:FLEMING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:503 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61571-1433
Mailing Address - Country:US
Mailing Address - Phone:309-282-6166
Mailing Address - Fax:
Practice Address - Street 1:503 MONROE ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:IL
Practice Address - Zip Code:61571-1433
Practice Address - Country:US
Practice Address - Phone:309-282-6166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist